【摘要】 目的总结病灶清除、植骨、内固定同时病灶置管灌注化疗脊柱结核的治疗疗效。方法从2000年10月~2011年11月手术治疗脊柱结核84例,结核病灶位于胸椎20例、胸腰段12例、腰椎34例、腰骶段18例,病灶范围1~3个椎体,无跳跃病灶。手术方法:治疗组42例行病灶清除、植骨、内固定同时病灶置管,术后卧床、正规抗结核同时用异烟肼0.1+利福霉素0.25+0.9%氯化钠5ml灌注化疗1次/d,7~10d拔管;42例对照组行病灶清除、植骨、内固定。均卧床3~5个月,抗结核药物治疗9~18个月,定期进行实验室检查和影像学观察。结果治疗组患者切口无窦道形成、内固定无断裂及松动、术后6个月X线片显示植骨融合、结核病灶全部治愈优于对照组。结论脊柱结核在手术彻底清除病灶和植骨消灭死腔,坚强内固定矫正畸形和重建脊柱稳定性同时通过病灶置管化疗是一种安全、有效的治疗方法。更多还原

【Abstract】 Objective Summary of debridement,bone grafting and internal fixation after lesion catheterization chemotherapy in postoperative treatment of spinal tuberculosis. Methods From October 2000 to November 2011,surgical treatment of spinal tuberculosis in 84 cases,located in 20 cases of thoracic vertebrae,thoracic and lumbar tuberculosis foci in 12 cases,34 cases of lumbar spine,lumbar sacral segment 18 cases,focus range 1 ~ 3 vertebral body,no skip lesions. Operation method: treatment,42 regular debridement,bone grafting and internal fixation at the same time focus tube. After operation,the formal resistance to isoniazid for tuberculosis while lying in bed in 0. 1+ rifamycin sodium chloride 0. 25+0. 9% 5ml infusion chemotherapy once a day,7 ~ 10 day extubation; 42 compared with the set of rows debridement,bone grafting and internal fixation. Bed 3 ~ 5 in both months,anti-TB drugs in treatment of 9 ~ 18 months,regular laboratory tests and imaging observation. Results Treatment group incision in patients with and without internal fixation with sinus tract formation,free for 6 months after breaking and loosening,X-ray film display fusion,tuberculosis cure all is better than the control group. Conclusion Thoroughly clear focus and bone graft in surgery spinal tuberculosis eradication of dead space,after internal rigid fixation for correction of deformity and reconstruction of spinal stability by catheterization chemotherapy lesion might be a safe and effective way.更多还原