摘要
目的:探讨耐药脊柱结核的外科治疗及疗效。方法:对2005年3月至2009年4月收治的60例耐药脊柱结核的临床资料进行回顾性分析,男36例,女24例,年龄5～79岁,平均47.3岁。其中34例患者有神经受损症状,神经功能按ASIA分级标准:A级2例,B级5例,C级13例,D级14例。根据病灶部位及病变程度采用经脊柱前路、肋横突或后路病灶清除、植骨、内固定。并在药敏试验结合耐药基因检测指导下抗结核治疗12～18个月。观察患者复发、神经功能恢复、植骨融合情况。结果:所有患者均获得随访,时间1～5年,平均3.1年。2例术后复发,经再次手术治愈。神经功能受损的34例,术后改善或完全恢复。X线或CT检查提示57例患者植骨融合。结论:对耐药脊柱结核,药敏试验结合耐药基因检测指导下抗结核治疗,个体化术式选择,有较好的临床疗效。
Objective：To study the curative effect of surgical treatment of drug resistant spinal tuberculosis.Methods：From March 2005 and April 2009,the clinical data of 60 patients with drug resistant spinal tuberculosis were retrospectively analyzed.Including 36 males and 24 females;aged from 5 to 79 years with an average of 47.3 years.Thirty four patients had neurological deficits,among them,2 cases were grade A,5 cases were grade B,13 cases were grade C,14 cases were grade D according to ASIA standard.According to the severity and location of the infection,the patients underwent anterior,posterolateral costotransversectomy or posterior debridement and bone grafting and internal fixation.The antituberculous chemotherapy for a total of 12 to 18 months was guided by conventional and genotypic drug susceptibility testing.Tubercular relapse,neurological function,spinal fusion were observed by ASIA grade,X ray and CT scan.Results：All cases were followed up from 1 to 5 years with an average of 3.1 years.Recurrence was found in 2 cases who were cured after second operation.34 cases with neurological deficits recovered totally or partially.X ray or CT films showed spinal fusion in 57 patients.Conclusion：The therapeutic effect of individuall operative options is good in treating drug resistant spinal tuberculosis after antituberculous chemotherapy based on conventional and genotypic drug susceptibility testing.
出处
《中国骨伤》
CAS
2010年第7期485-487,共3页
China Journal of Orthopaedics and Traumatology
关键词
结核
脊柱
外科手术
结核
抗多种药物性
Tuberculosis spinal Surgical procedures operative Tuberculosis multidrug resistant
