临床误诊误治2019，Vol.32Issue(3)：76-80,5.DOI:10.3969/j.issn.1002-3429.2019.03.017
三种不同手术入路治疗成人腰椎结核的中期效果分析
Comparison of the Mid-term Efficacy of Three Different Surgical Approaches for the Treatment of Lumbar Spinal Tuberculosis in Adults
摘要
Abstract
Objective To investigate the mid-term efficacy of three different surgical approaches for the treatment of lumbar spinal tuberculosis in adults. Methods Eighty-four adults with lumbar spinal tuberculosis admitted to our hospital from March 2015 to July 2017 were selected. According to random number table method, they were divided into simple anterior approach group, simple posterior approach group and anterior-posterior approach group, with 28 cases in each group. The three groups underwent simple anterior approach, simple posterior approach, and anterior-posterior approach combined with debridement and bone graft fusion, respectively. The duration of operation, intraoperative blood loss, and postoperative bed rest time were recorded. The Frankel scale was used to assess neurological function of the spinal cord after treatment. Cobb angle and erythrocyte sedimentation rate (ESR) were measured before operation, and 14 d and 3 months after operation. The occurrence of postoperative complications was observed. Results There were significant differences in duration of operation, intraoperative blood loss and postoperative bed rest time among the three groups (P＜0.001). Compared with the anterior-posterior approach group, the duration of operation and postoperative bed rest time were significantly shorter in the simple anterior approach group and simple posterior approach group and the intraoperative blood loss was significantly decreased (P＜0.05). Compared with the simple posterior approach group, the intraoperative blood loss in the simple anterior approach group was increased, and the difference was statistically significant (P＜0.05). There was no significant difference in the Frankel scale among the three groups after treatment (P＞0.05). Compared with those before operation, the ESR and Cobb angles of the three groups were decreased at 14 d and 3 months after operation, and there were significant differences (P＜0.05). The complication rates of the simple anterior approach group, the simple posterior approach group, and the anterior-posterior approach group were 17.86％, 10.71％, and 39.29％ respectively, and the difference was statistically significant (P＜0.001). Conclusion The reasonable clinical approach should be based on the condition of adult patient with lumbar spinal tuberculosis to obtain a good mid-term efficacy, and to improve neurological function and prognosis of the patient.关键词
结核,脊柱/外科手术/手术入路/疗效比较研究Key words
Tuberculosis, spinal/Surgical procedures, operative/Operative route/Comparative effectiveness research分类
医药卫生引用本文复制引用
罗成辉,符江..三种不同手术入路治疗成人腰椎结核的中期效果分析[J].临床误诊误治,2019,32(3):76-80,5.基金项目
四川省科技厅资助项目(2015SM1241) （2015SM1241）
