[1]陈宏亮,段钢,袁峰,等.一期外科手术联合局部应用利福平粉剂治疗胸腰椎结核的临床疗效[J].徐州医科大学学报,2020,40(11):800-804.[doi:10.3969/j.issn.2096-3882.2020.11.005]
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一期外科手术联合局部应用利福平粉剂治疗胸腰椎结核的临床疗效()
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《徐州医科大学学报》[ISSN:2096-3882/CN:32-1875/R]

卷:
40
期数:
2020年11期
页码:
800-804
栏目:
出版日期:
2020-11-25

文章信息/Info

Title:
Clinical observation of one-stage surgical operation combined with local application of rifampicin powder in the treatment of thoracic and lumbar tuberculosis
作者:
陈宏亮段钢袁峰郭开今
徐州医科大学附属医院骨科,江苏 徐州 221002;徐州医科大学第二附属医院骨科,江苏 徐州 221002;徐州市中心医院皮肤外科,江苏 徐州 221009
关键词:
脊柱结核 病灶清除 局部 利福平粉剂
DOI:
10.3969/j.issn.2096-3882.2020.11.005
文献标志码:
A
摘要:
目的 探讨行一期病灶清除植骨内固定术联合局部应用利福平粉剂治疗胸腰椎结核的临床疗效.方法 选取2015年7月—2017年6月在徐州医科大学附属医院行一期胸腰椎结核病灶清除加植骨内固定手术的53例患者,收集临床资料进行回顾性分析.将联合局部应用利福平粉剂者设为A组,共26例;将单纯行病灶清除植骨内固定手术者设为B组,共27例.记录2组患者手术时间、手术出血量、住院时间.检测2组患者术后1、3、7、14 d的红细胞沉降率(ESR)和谷丙转氨酶(ALT)指标,门诊随访检测术后1、3、6、12、18个月时的ESR和ALT指标.比较2组患者手术前后脊柱后凸Cobb角和脊髓损伤Frankel评分.比较2组患者术后愈合情况和药物不良反应.结果 2组患者手术时间、手术出血量、住院时间比较,差异无统计学意义(P>0.05).术后1个月2组患者的ESR和ALT指标恢复至正常范围内,2组间术后ESR和ALT值比较,差异无统计学意义(P>0.05).与术前相比,2组患者术后脊柱后凸Cobb角减小,脊髓损伤Frankel评分升高,差异有统计学意义(P<0.05).术后A组治愈后复发率较B组更低,差异有统计学意义(P<0.05);2组术后病灶植骨融合率及融合时间比较,差异无统计学意义(P>0.05).所有患者均未见明显药物不良反应.结论 对胸腰椎脊柱结核患者行一期病灶清除植骨内固定术是治疗脊柱结核有效的手术方式,联合局部应用利福平粉剂可以降低局部复发率,且操作安全方便,具有一定的临床应用价值.
Abstract:
ob<x>jective To investigate the clinical effect of one-stage debridement, bone graft and internal fixation combined with local application of rifampicin powder in the treatment of thoracic and lumbar tuberculosis. Methods A retrospective analysis was made on 53 patients who underwent one-stage thoracic and lumbar tuberculosis focus removal and bone grafting and internal fixation surgery in our hospital from July 2015 to June 2017. Among them, 26 patients who underwent combined local application of rifampicin powder were set as group A; Twenty-seven patients in group B were treated with regular antituberculosis therapy in the whole process. The clinical effects of the two groups were compared. Results There was no significant difference between the two groups in terms of operation time, blood loss and hospitalization time (P>0.05). There was no significant difference in ESR value, liver function index and anti-tuberculosis adverse drug reactions between the two groups during postoperative follow-up (P>0.05). The Cobb angle of postoperative kyphosis in the two groups decreased compared with that before operation, and the difference was statistically significant (P<0.05), while there was no statistically significant difference between the two groups (P>0.05). Frankel score of spinal cord nerve injury in the last follow-up of the two groups was higher than that before treatment, and the difference was statistically significant (P<0.05). There was no significant difference in the fusion rate and fusion time between the two groups (P>0.05). There was significant difference in recurrence rate between the two groups (P<0.05). Conclusion One-stage debridement, bone grafting and internal fixation for thoracic and lumbar spinal tuberculosis patients is an effective surgical method for the treatment of spinal tuberculosis. Combined local use of rifampicin powder can reduce the local recurrence rate, and is safe and convenient to operate, which has certain clinical application value
更新日期/Last Update: 2020-12-15