| 两种术式治疗腰椎结核伴腰大肌脓肿的病例对照研究 |
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投稿时间：2015-05-15
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| 期刊信息：《中国骨伤》2016年，第29卷，第1期，第33-37页 |
| DOI：10.3969/j.issn.1003-0034.2016.01.008 |
| 基金项目: |
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中文摘要:
目的:通过比较两种术式治疗腰椎结核伴腰大肌脓肿的临床疗效,为临床合理选择治疗方式提供参考。
方法:回顾性分析2010年1月至2013年1月连续收治的腰椎结核伴腰大肌脓肿患者42例,男24例,女18例;年龄21～63岁,平均(38.5±10.2)岁;随访时间18～24个月,平均20.9个月。根据治疗方案的选择,将患者分为A、B两组:A组22例,行后路椎体病灶清除、植骨融合内固定术,联合经皮穿刺置管引流腰大肌脓肿治疗;B组20例,行前路经腹膜外脓肿清除、后路椎体病灶清除植骨融合内固定术。对两组患者的手术时间、出血量、住院时间、临床治愈率等进行对比分析。
结果:术中出血量A组为(452.3±137.6) ml,B组为(603.5±99.6) ml;手术时间A组为(193.6±91.2) min,B组为(230.5±56.6) min.A组平均手术时间及出血量少于B组(P<0.05).A组:Ⅰ期治愈20例,复发2例;B组,Ⅰ期治愈19例,复发1例,两组患者Ⅰ期治愈率比较差异无统计学意义(χ2=0.000,P=1.000).两组患者住院时间比较差异无统计学意义(P>0.05).
结论:腰椎结核伴腰大肌脓肿不是前路开放手术的绝对适应证,相对于前后路联合手术,经皮穿刺脓肿置管引流联合后路椎体病灶清除术,在达到相同临床效果的同时,对患者的创伤更小。 |
| 【关键词】腰椎 结核,脊柱 腰肌脓肿 穿刺术 引流术 |
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| Case-control studies of two kinds of method for the treatment of lumbar tuberculosis with psoas abscess |
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ABSTRACT
Objective:To compare two kinds of method for treating lumbar tuberculosis with psoas abscess,to provide reference for clinical reasonable select of therapy treatment.
Methods:From January 2010 to January 2013,42 patients with lumbar tuberculosis combined with psoas abscess with obvious surgical indications were enrolled,including 24 males and 18 females with an average age of (38.5±10.2) years old ranging from 21 to 63 years old. All patients were followed up for 18 to 24 months with an average of 20.9 months. Twenty-two patients underwent posterior vertebral body lesions cleared,bone graft fusion and internal fixation and percutaneous puncture catheter drainage for treatment of psoas major abscess as group A,and twenty patients underwent one-stage extraperitoneal approach to remove abscess,posterior vertebral body lesions cleared,bone graft fusion and internal fixation as group B. The operative time,loss of blood,length of hospital stay,clinical cure rate and other clinical results for the two groups were analyzed and compared.
Results:The loss of blood was (452.3±137.6) ml in group A and (603.5±99.6) ml in group B,there was significant statistical difference (P<0.05). The time of operation was (193.6±91.2) min in group A and (230.5±56.6) min in group B,there was significant statistical difference (P<0.05). The time of operation and the loss of blood in group A were obviously less than which in group B. In group A 20 cases were cured and 2 cases relapsed,19 cases were cured and 1 case relapsed in group B,there was no significant statistical differences between two groups regarding cure rate with chi-square test (χ2=0.000,P=1.000). All patients in two groups obtained good clinical curative effect. There were no significant statistical difference between two groups regarding for length of hospital stay with t-test(P>0.05).
Conclusion:Lumbar spinal tuberculosis with psoas abscess is not absolute indications for anterior open operation. Compared with the combined anterior and posterior surgical procedure,the percutaneous puncture catheter drainage combined with posterior debridement,interbody fusion and internal fixation can achieve the same clinical effect but less trauma for the patients. |
| KEY WORDS Lumbar vertebrae Tuberculosis,spinal Psoas abscess Puncture Drainage |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 王琦,胡明,马远征,罗小波.两种术式治疗腰椎结核伴腰大肌脓肿的病例对照研究[J].中国骨伤,2016,29(1):33~37 |
| 英文格式: | WANG Qi,HU Ming,MA Yuan-zheng,LUO Xiao-bo.Case-control studies of two kinds of method for the treatment of lumbar tuberculosis with psoas abscess[J].zhongguo gu shang / China J Orthop Trauma ,2016,29(1):33~37 |
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