【摘要】 目的探讨脊柱结核术后复发,切口不愈合与术前营养不良、低蛋白血症的关系。方法采用病灶清除术加前路或后路内固定植骨融合术治疗胸腰椎结核160例,其中男76例,女84例;年龄17～73岁,平均39.7岁。病程3个月至7年,平均17个月。胸椎结核46例,胸腰段结核40例,腰椎结核74例。以术前血浆白蛋白是否大于35g/L为界线分组:A组76例(血浆白蛋白≥35g/L),B组84例(血浆白蛋白≤35g/L),两组患者手术前后抗结核治疗程序一致。观察指标:远期指标结核复发率及植骨融合率,近期指标为伤口引流量、愈合情况,血沉及血浆白蛋白恢复情况。结果 160例患者,142例获随访,A组有5例出现复发,1例切口裂开,2例内固定失败,B组8例复发,3例切口愈合不良,4例内固定失败。B组患者术后切口引流量较A组明显增加,血沉及蛋白恢复情况缓慢,两组有统计学意义(P<0.05)。结论术前营养不良直接影响切口愈合及结核复发情况,血浆白蛋白值应当做为脊柱结核手术时机选择的指标之一。更多还原

【Abstract】 Objective To explore the relation between malnutrition preoperative and postoperative recurrence of spinal tuberculosis and jargon disunion.Methods Totally 160 cases(76 males and 88 females,ranging from 17 to 73 years with an average of 39.3 years,and the average pathogenesis is 17 months,ranging from 3 months to 7 years,spinal TB mostly involved 46 thoracic,40 thoralumbar and 74 lumbar level.Patients were divided into two groups according to the preoperative value of plasma-albumin:group A 74(≥35g/L) ,and group B(plasma-albumin <35g/L) .Patients in two groups were treated by the same method.The long-term indexes including postoperative recurrences and the bone fusion rates,and the short-term indexes including jargon disunion,the effusion,and the recovery of ESR,plasma-albumin.Results Among 160 patients,142 were followed up.In group A,the recurred cases were 5,the incision cracked is 1,and the internal fixation failures are 4,in group B,the number is 8,3,4.Conclusions Plasma-albumin preoperative is a very important factor to choose the right operative time on the surgery of spinal tuberculosis.更多还原