抗结核药物联合一期后路病灶清除植骨融合内固定矫形治疗成人胸椎段结核的效果

摘要

Objective To evaluate the surgical efficacy of anti tuberculosis drugs combined with one stage posterior ap-proach to remove bone graft fusion and internal fixation in the treatment of adult thoracic tuberculosis. Methods From January 2014 to January 2015, in the First Affiliated Hospital of Xinxiang Medical University, 75 patients with thoracic vertebrae tuberculosis were selected, they were given anti tuberculosis drugs combined with one stage posterior ap-proach to remove bone graft fusion and internal fixation . The kyphosis Cobb's angle,erythrocyte sedimentation rate (ESR) and American Spinal Injury Association (ASIA) grade before and after surgery were reviewed and compared. Re-sults After the surgery, patients improved to varying degrees of neurological function and recovery, the ASIA grade were better than those before the surgery, the difference was statistically significant (P<0.01). After the surgery imme-diately, ESR, Cobb angle of patients were compared with those before the surgery, the differences were statistically sig-nificant (P<0.01);ESR, Cobb angle of patients After the surgery 3 months were compared with those before the surgery, the differences were statistically significant (P<0.01);ESR after the surgery immediately were compared with those be-fore the surgery, the differences were statistically significant (P<0.01). Conclusion One-stage radical debridement and bone graft fusion combined with internal fixation for treatment thoracic vertebrae tuberculosis via anterior thoracic ap-proach is effective safe and reliable, it can be widely used in clinical.%目的：评价抗结核药物联合一期后路病灶清除植骨融合内固定矫形治疗成人胸椎结核的效果。方法选取2014年1月~2015年1月新乡医学院第一附属医院院就诊的胸椎段结核患者75例。对患者进行抗结核药物联合一期后路病灶清除植骨融合内固定矫形治疗，比较手术前后美国脊髓损伤神经学分类国际标准损伤分级(ASIA)情况及术血沉(ESR)、Cobb角的差异。结果患者术后神经功能得到不同程度的改善和恢复，ASIA分级与术前比较，差异有高度统计学意义(P<0.01)。患者术后即刻ESR和Cobb角与术前比较，差异有高度统计学意义(P<0.01)；术后3个月的ESR和Cobb角与术前比较，差异有高度统计学意义(P<0.01)；术后3个月的ESR与术后即刻比较，差异有高度统计学意义(P<0.01)。结论抗结核药物联合一期后路病灶清除植骨融合内固定矫正治疗成人胸椎结核效果确切，且安全可靠，临床可以推广使用。