经皮穿刺活检冲洗置药术治疗脊柱结核的疗效分析

摘要

Objective To explore the efficacy of C-arm X-ray image-guided percutaneous transpedicular biop-sy,rinse and local medication in the treatment of spinal tuberculosis . Methods 15 patients with spinal tuberculosis treated by C-arm X-ray image-guided percutaneous transpedicular biopsy,rinse and local medication were analyzed retrospectively. The convex angle,Oswestry Dysfunction Index (ODI),routine laboratory examination as well as X-ray examination were used to evaluate the recovery of the patients 'condition. Results All of the operations were successfully performed. The followed -up period ranged from 11 to 60 months. The convex angle was obviously reduced from (13.49 ±2.12)° before operation to (6. 58 ± 1.08)° at the final follow-up,the difference was statistically significant (P < 0.01 ) . The ODI score was improved from 43. 26 ±23. 63 before operation to 12. 62 ±8. 56 at the final followed -up,the difference was statistically significant (P <0.01 ). The blood routine test,erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) gradually decreased to normal. The intervertebral space basically fused,no severe complications occurred. Conclusion C-arm X-ray image-guided percutaneous transpedicular biopsy,rinse and local medication is a safe and effective method in the treatment of spinal tuberculosis .%目的 探讨C型臂X线机引导下经皮经椎弓根穿刺活检冲洗置药术在治疗脊柱结核中的应用.方法 对C型臂X线机引导下经皮经椎弓根穿刺活检冲洗置药术治疗的15例脊柱结核患者的临床资料进行回顾性分析,根据治疗前以及终末随访时后凸角(患椎头尾侧的椎间角)、Oswestry功能障碍指数(ODI)、实验室检查及X线检查对患者病情恢复情况进行评价.结果 所有患者手术顺利.随访11～60个月,治疗前后凸角为(13.49±2.12)°,终末随访时为(6.58±1.08)°,两者差异有统计学意义(P<0.01).术前ODI评分为43.26±23.63,终末随访时为12.62±8.56,两者差异有统计学意义(P<0.01).患者血常规、红细胞沉降率(ESR)及C-反应蛋白(CRP)逐渐降至正常,椎间隙基本融合,无严重并发症发生.结论 C型臂X线机引导下经皮经椎弓根穿刺活检冲洗置药术是治疗脊柱结核安全有效的方法.