摘要
目的探讨脊柱结核并截瘫患者提早手术的安全性。方法应用荧光定量聚合酶链反应技术,对22例一般情况稳定,术前抗痨治疗小于2周,红细胞沉降率(ESR)未降至正常且伴有截瘫或截瘫呈进行性加重的脊柱结核患者,分别在手术前1 d及术后第2天采集外周血标本。通过提取DNA、PCR扩增,进行结核分支杆菌的DNA荧光定量检测。结果该组脊柱结核手术患者术前的外周血中结核分支杆菌DNA阳性率为9/22(40.9%),术后患者的外周血中结核分支杆菌DNA阳性率分别为10/22(45.4%)。对该组手术患者手术前、后外周血结核分支杆菌DNA含量进行统计学分析,t=0.702,P=0.494,按α=0.05水准,结果无统计学意义,提示该组手术患者手术前、后外周血结核分支杆菌DNA含量无差别(P>0.05)。结论手术对这类脊柱结核患者结核杆菌在体内播散的程度没有明显影响;对于这类脊柱结核患者,尽管术前ESR未降至正常,且抗痨时间小于2周,在完善相关术前准备、无其他手术禁忌的情况下,提早手术治疗,是安全、可行的。
[Objective] To discuss the earlier operation security of the patients with spinal tuberculosis combine paraplegia. [Method] We selected 22 spinal tuberculosis patients combine paraplegia or aggravating in progress, who had been treated with anti-tuberculosis drug less than 2 weeks and were in stable condition, and their ESR decreased to normal. Their peripheral blood was drawn on 2 days before and after operation. After extracting DNA and PCR amplification, the mycobacterium tuberculosis DNA content with fluorescent quantitation was detected. [Resuit] In this group, preoperative positive rate of Mycobacterium tuberculosis DNA in peripheral blood was 9/22 （40.9%）, and the postoperative positive rate was 10/22 （45.4%）. Statistical analysis of the mycobacterium tuberculosis DNA content of the preoperation and postoperation showed t =0.702, P =0.494 （a =0.05, P 〉0.05）. There was no significant： difference in the two sets, which demonstrated the tuberculosis DNA content of the pre- and post-operative patients had no difference in this group. [Conclusion] The operation effects were few about the mycobacterium tu- berculosis vivo dissemination in this group spinal tuberculosis patients; Although their ESR didn＇t decrease to normal and their anti-tuberculosis treating time was less than 2 weeks, the earlier operation was absolutely feasible to such spinal tuberculosis patients when the preoperative preparation is consummate and without any contraindication.
出处
《中国医学工程》
2007年第7期548-551,554,共5页
China Medical Engineering
基金
湖南省科技厅科"技计划重点项目"课题(05SK2004)
