| 老年人脊柱结核21例回顾性分析 |
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| 作者 | Author | 单位 | Address | E-Mail |
| 李勇 |
LI Yong |
解放军第11医院骨科,新疆伊宁835000 |
The 11th Hospital of PLA,Yining 835000,Xinjiang,China |
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| 刘兴炎 |
LIU Xing-yan |
兰州军区总医院创伤骨科中心 |
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| 甄平 |
ZHEN Ping |
兰州军区总医院创伤骨科中心 |
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| 黄光海 |
HUANG Guang-hai |
解放军第11医院骨科,新疆伊宁835000 |
The 11th Hospital of PLA,Yining 835000,Xinjiang,China |
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| 田乃宜 |
TIAN Nai-yi |
解放军第11医院骨科,新疆伊宁835000 |
The 11th Hospital of PLA,Yining 835000,Xinjiang,China |
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| 曾凡本 |
ZENG Fan-ben |
解放军第11医院骨科,新疆伊宁835000 |
The 11th Hospital of PLA,Yining 835000,Xinjiang,China |
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| 期刊信息：《中国骨伤》2007年，第20卷，第3期，第163-164页 |
| DOI：doi:10.3969/j.issn.1003-0034.yyyy.nn.zzz |
| 基金项目: |
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中文摘要:
目的:探讨老年人脊柱结核发生、发展的原因、临床特点和治疗原则。
方法:回顾21例老年人脊柱结核的临床资料,男13例,女8例,年龄60~82岁。其中胸椎结核7例,胸腰段结核2例,腰椎结核12例。2个椎体破坏15例,3个椎体破坏5例,跳跃式椎体破坏1例。根据结核并发症、合并症及抗痨疗效决定治疗方案。其中手术治疗15例,术前均抗痨治疗2周,采用Ⅰ期椎弓根内固定并病灶清除手术治疗。6例因合并症重行单纯抗痨保守治疗。
结果:15例手术病例中13例术后得到随访,平均随访20.1个月,其中2例单个椎弓根钉断裂,1例单侧支撑棒断裂,无假关节形成,植骨融合满意。9例治愈,2例缓解(截瘫部分改善),2例复发。未手术6例门诊随访2年均因合并症死亡。
结论:老年人脊柱结核以胸椎及腰椎结核常见,单纯保守治疗效果差,手术治疗是重要途径,Ⅰ期病灶清除并坚强内固定治疗可以取得良好疗效。 |
| 【关键词】结核,脊柱 胸椎 腰椎 老年人 骨折固定术,内 |
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| Retrospective study on 21 elderly patients with spinal tuberculosis |
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ABSTRACT
Objective: To study occurrence and developing reasons on spinal tuberculosis in elderly patients,as well as to explore its clinical characteristics and treatment.
Methods: Twenty-one patients(13 male and 8 female,ranging in age from 60 to 82 years) were reviewed in the study.Among the patients,7 patients had tuberculosis of thoracic spine,2 patients had tuberculosis of thoracic and lumbar spine,and 12 patients had!tuberculosis of lumbar spine.Two vertebrae were damaged in 15 patients,three vertebrae were damaged in 5 patients,and vertebrae were skipped damaged in one patient.The treatment prescription was selected based on the tuberculous complications,and therapeutic effects of antituberculosis.In the study,15 patients were treated with operation of one-stage transpedicular internal fixation combined with focal debridement after two weeks of antituberculosis treatment,and other 6 patients were treated with simple antituberculosis because of serious complications.
Results: Among 15 patients treated with operation,13 were followed for an average of 20.1 months,and single screw broken in 2 patients,one-side rod broken in 1 patient without pseudoarticulation formation.Among the 13 patients,9 were healed,2 patients had symptoms relieved and 2 patients had symptoms recurred.Six patients who were treated with conservative methods died of complications after 2 years follow-up.
Conclusion: The spinal tuberculosis in elderly patients often occurs in thoracic lumbar spine,which should be treated with surgery.One-stage focal debridement combined with strong internal fixation is an effective way to treat this disease. |
| KEY WORDS Tuberculosis,spinal Thoracic vertebrae Lumbar vertebrae Aged Fracture fixation,internal |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 李勇,刘兴炎,甄平,黄光海,田乃宜,曾凡本.老年人脊柱结核21例回顾性分析[J].中国骨伤,2007,20(3):163~164 |
| 英文格式: | LI Yong,LIU Xing-yan,ZHEN Ping,HUANG Guang-hai,TIAN Nai-yi,ZENG Fan-ben.Retrospective study on 21 elderly patients with spinal tuberculosis[J].zhongguo gu shang / China J Orthop Trauma ,2007,20(3):163~164 |
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