【摘要】 目的: 探讨胸腰椎结核前路病灶清除内固定治疗效果。方法： 自2004年4月～2007年4月我院治疗胸腰椎结核268例，采用病灶清除+植骨融合112例，病灶清除+植骨融合+内固定156例。结果: 本组268例患者中，1例术后第2天因心、肺、肾功能衰竭转ICU，抢救无效死亡，其余病例手术切口I期愈合，脊柱后突畸形得到不同程度的矫正，局部疼痛缓解，神经症状有不同程度的恢复，内固定组术后无复发，非内固定组术后复发32例。结论： 术前、术中、术后抗痨治疗同时I期行前路病灶清除植骨内固定治疗胸腰椎结核是一种可行的治疗方法。
【关键词】 胸腰椎结核; 病灶清除; 植骨; 内固定
The approach of therapeutic efficacy on anterior focus debridement with autogenous bone grafts and internal fixation in treatment of tuberculosis of thoracic or lumbar spine
WANG Fa-zheng, LI Mao-zhao, Abulikemu·Abudurexiti, et al
(First People’s Hospital of Kashi Erefecture, Kashi 844000, China)
Abstract: Objective: To approach the therapeutic efficacy on tuberculosis of thoracic or lumbar spine treated by anterior focus debridement with autogenous bone grafts and internal fixation. Methods: We selected 268 patients of tuberculosis of thoracic or lumbar spine treated from the April of 2004 to the April of 2007 in our hospital, including 112 treated by focus debridement combined with bone grafts and arthrodesis; 156 treated by the former combined with internal fixation. Rresults: One of 268 patients had to be shifted to ICU owing to functional failures of heart, lung and kidney, and at last was dead without a successful savage. However, the others had the I grade healing of operative incision with deformities of kyphosis rectified by the different degree, local pains relieved and neural symptoms also recovered. At the same time there was no recurrence in the group of inernal fixation, whereas 32 in the group of non-internal fixation. Conclusion: Anterior focus debridement with autogenous bone grafts and internal fixation of I term adding the Preo-, intra-and postoperative anti-tuberculosis treating tuberculosis of thoracolumbar spine is a feasible therapeutic method .
Key words: tuberculosis of thoracic or lumbar spine; focus debridement; bone grafts; internal fixation
骨与关节结核最常见的是脊椎结核，占骨与关节结核的60%[1]。病灶清除、
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