脊柱结核个体化的手术治疗

摘要

Objective:To observe different surgical methods and clinical efficacy of spine tuberculosis.Method:A total o f 76 cases with spine tuberculosis treated in our hospital between 2004 and 2010 were reviewed. After anti-tuberculosis treatment,all cases accepted different surgery according to the levels and severity of different cases.Result: None of the cases were death or get worse after operation.The operation time was 70-150 minutes(average 130 minutes).The blood loss during the operation was 100-2000 ml(average 800 ml).The lower limbs and excretory function of the nine paraplegia patients convalesce 3-6 months after surgery.All the cases had a follow-up of no less than 12 months ,no relapse. Conclusion:Due to anatomical site of damage in varying degrees and be complicated by various complications,the spinal tuberculosis should be treated with individualized plan.%　　目的：探讨脊柱结核不同手术方法的治疗效果.方法：自2004-2010年间收治脊柱结核76例,术前经过严格的化疗后,根据患者发病部位、脊柱破坏的程度、脊柱节段破坏的多少选择个体化的手术治疗.结果：本组病例无一例出现死亡和病情加重现象.手术时间70~150 min,平均130 min.出血量100~2000 ml,平均800 ml.在9例截瘫患者中,经手术治疗后分别在术后3~6个月逐渐恢复下肢和大小便功能.本组病例经随访12个月以上无一例出现复发.结论：近年来脊柱结核在临床有增多趋势,其手术入路的选择仍存在很多争议,只要根据患者发病部位、脊柱破坏的程度、脊柱破坏节段的多少、手术熟练的程度和工作经验的积累,实行个体化治疗,才能取得好的治疗效果.