| 耐药脊柱结核的外科治疗 |
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Received:May 24, 2010
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| 作者 | Author | 单位 | Unit | E-Mail |
| 李大伟 |
LI Da-wei |
中国人民解放军第309医院骨科，北京 100091 |
Department of Orthopaedics,the 309th Hospital of PLA,Beijing 100091,China |
myzzxq@sina.com |
| 马远征 |
MA Yuan-zheng |
中国人民解放军第309医院骨科，北京 100091 |
Department of Orthopaedics,the 309th Hospital of PLA,Beijing 100091,China |
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| 侯英 |
HOU Ying |
解放军结核病中心研究室 |
Department of Orthopaedics,the 309th Hospital of PLA,Beijing 100091,China |
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| 薛海滨 |
XUE Hai-bin |
中国人民解放军第309医院骨科，北京 100091 |
Department of Orthopaedics,the 309th Hospital of PLA,Beijing 100091,China |
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| 黄凤山 |
HUANG Feng-shan |
中国人民解放军第309医院骨科，北京 100091 |
Department of Orthopaedics,the 309th Hospital of PLA,Beijing 100091,China |
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| 期刊信息：《中国骨伤》2010年23卷，第7期，第485-487页 |
| DOI：10.3969/j.issn.1003-0034.2010.07.003 |
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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。 |
| [关键词]:结核，脊柱 外科手术 结核，抗多种药物性 |
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| Surgical treatment of drug-resistant spinal tuberculosis |
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Abstract:
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. |
| KEYWORDS:Tuberculosis,spinal Surgical procedures,operative Tuberculosis,multidrug-resistant |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 李大伟,马远征,侯英,薛海滨,黄凤山.耐药脊柱结核的外科治疗[J].中国骨伤,2010,23(7):485~487 |
| 英文格式: | LI Da-wei,MA Yuan-zheng,HOU Ying,XUE Hai-bin,HUANG Feng-shan.Surgical treatment of drug-resistant spinal tuberculosis[J].zhongguo gu shang / China J Orthop Trauma ,2010,23(7):485~487 |
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