| 经皮脊柱内镜清创灌洗在骶髂关节结核中的临床应用 |
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投稿时间：2020-10-22
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| 作者 | Author | 单位 | Address | E-Mail |
| 管晓鹂 |
GUAN Xiao-li |
兰州大学第二医院骨四病区, 甘肃 兰州 730030 |
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| 薛文 |
XUE Wen |
甘肃省人民医院骨2科, 甘肃 兰州 730000 |
The Second Department of Orthopaedics, Gansu Provincial People's Hospital, Lanzhou 730000, Gansu, China |
xuewendoctor@sina.com |
| 王栋 |
WANG Dong |
甘肃省人民医院骨2科, 甘肃 兰州 730000 |
The Second Department of Orthopaedics, Gansu Provincial People's Hospital, Lanzhou 730000, Gansu, China |
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| 马娅琼 |
MA Ya-qiong |
甘肃省人民医院骨2科, 甘肃 兰州 730000 |
The Second Department of Orthopaedics, Gansu Provincial People's Hospital, Lanzhou 730000, Gansu, China |
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| 张群立 |
ZHANG Qun-li |
甘肃省人民医院骨2科, 甘肃 兰州 730000 |
The Second Department of Orthopaedics, Gansu Provincial People's Hospital, Lanzhou 730000, Gansu, China |
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| 刘林 |
LIU Lin |
甘肃省人民医院骨2科, 甘肃 兰州 730000 |
The Second Department of Orthopaedics, Gansu Provincial People's Hospital, Lanzhou 730000, Gansu, China |
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| 马志宇 |
MA Zhi-yu |
东乡县人民医院骨科, 甘肃 东乡 731800 |
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| 马健 |
MA Jian |
东乡县人民医院骨科, 甘肃 东乡 731800 |
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| 期刊信息：《中国骨伤》2021年，第34卷，第11期，第1006-1010页 |
| DOI：10.12200/j.issn.1003-0034.2021.11.004 |
| 基金项目:甘肃省人民医院院内研发攻关项目（编号：18GSSY3-9） |
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中文摘要:
目的：探讨经皮脊柱内镜清创灌洗治疗骶髂关节结核的可行性及临床疗效。
方法：对2007年1月至2009年4月采用皮脊柱内镜清创灌洗治疗的7例骶髂关节结核患者进行回顾性分析。其中男2例，女5例；年龄29~69岁；病变部位右侧4例，左侧3例；病程8~144个月；按Kim分型，Ⅲ型5例，Ⅳ型2例。患者术前均应用HRZE四联抗结核药物治疗2~6周。比较手术前后的视觉模拟评分（visual analogue scale，VAS），红细胞沉降率（erythrocyte sedimentation rate，ESR），C-反应蛋白（C-reactive protein，CRP），Oswestry功能障碍指数（Oswestry Disability Index，ODI）。
结果：7例患者手术顺利，术中平均出血量<50 ml，无血肿、感染等并发症发生。7例患者的随访时间为18~40个月。疼痛缓解明显，术后1、3、6、12、18个月VAS、ESR、CRP、ODI与治疗前比较，均有改善，末次随访时临床、影像学及实验室检查显示感染消除，并恢复正常生活和工作。
结论：经皮脊柱内镜清创灌洗其组织创伤小、靶向操作、疗效肯定、术后恢复快，为骶髂关节结核的微创治疗探索出了新的选择。 |
| 【关键词】骶髂关节 结核,骨关节 清创术 微创外科手术 |
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| Clinical application of percutaneous spinal endoscopy debridement and lavage in sacroiliac joint tuberculosis |
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ABSTRACT
Objective: To investigate the feasibility and clinical efficacy of percutaneous spinal endoscopic debridement and lavage for the treatment of sacroiliac joint tuberculosis.
Methods: The clinical data of 7 patients with sacroiliac joint tuberculosis treated with percutaneous spinal endoscopic debridement and lavage from January 2007 to April 2009 were retrospectively analyzed. There were 2 males and 5 females, aged from 29 to 69 years old, 4 cases on the right side of the lesion and 3 cases on the left side. The course ranged from 8 to 144 months. According to Kim classification, 5 cases were type Ⅲ and 2 cases were type Ⅳ. All patients were treated with HRZE quadruple anti-tuberculosis drugs for 2 to 6 weeks before operation. VAS, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and Oswestry Disability Index (ODI) were compared before and after surgery.
Results: All the operations were successful, the intraoperative blood loss was less than 50 ml on average, and no complications such as hematoma and infection were occurred. The follow-up time of 7 cases ranged from 18 to 40 months. Pain relief was obvious, and there was a statistical result in the VAS, ESR, and ODI of the patients at 1, 3, 6, 12, 18 months after operation compared with before treatment. At the final follow-up, the patient's clinical, imaging and laboratory examinations showed that the infection had disappeared, and the patient returned to normal life and work.
Conclusion: Percutaneous spine endoscopic debridement and lavage has less tissue trauma, targeted operation, definite curative effects, and quick postoperative recovery, which has explored new options for minimally invasive treatment of sacroiliac joint tuberculosis. |
| KEY WORDS Sacroiliac Joint Tuberculosis,osteoarticular Debridement Minimal surgical procedures |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 管晓鹂,薛文,王栋,马娅琼,张群立,刘林,马志宇,马健.经皮脊柱内镜清创灌洗在骶髂关节结核中的临床应用[J].中国骨伤,2021,34(11):1006~1010 |
| 英文格式: | GUAN Xiao-li,XUE Wen,WANG Dong,MA Ya-qiong,ZHANG Qun-li,LIU Lin,MA Zhi-yu,MA Jian.Clinical application of percutaneous spinal endoscopy debridement and lavage in sacroiliac joint tuberculosis[J].zhongguo gu shang / China J Orthop Trauma ,2021,34(11):1006~1010 |
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