前路及后路病灶清除术治疗腰椎结核疗效比较分析.docVIP

前路及后路病灶清除术治疗腰椎结核疗效比较分析 　　[摘要] 目的 探讨前路及后路病灶清除术治疗腰椎结核的临床疗效差异，为临床提供可以借鉴的依据。 方法 共收治腰椎结核患者62例，随机分为前入路组（31例）、后入路组（31例），择期行病灶清除+植骨融合+内固定术，比较两组的手术时间、出血量、住院时间、术后1个月及3个月血沉（ESR）、cobb角、骨融合及术后复发等情况。 结果 前入路组的出血量、术后3个月ESR、术后12个月cobb角及复发例数优于后入路组，差异均有统计学意义（均P 0.05）。 结论 临床治疗腰椎结核入路选择有相对指征，但前入路较后入路有出血少、矫正角度丢失少、植骨融合快、复发率小等优点，临床效果更好。 　　[关键词] 腰椎结核；病灶清除；植骨融合；内固定 　　[中图分类号] R529.2 [文献标识码] A [文章编号] 1673-7210（2012）01（c）-0069-02 　　 　　Comparative analysis of efficacy of anterior and posterior debridement in treatment of lumbar vertebral tuberculosis 　　LI Shuofu1 HUANG Xiangwang2 LIU Xiangyang2 XIAO Sheng2 LIU Hongzhe2 SHEN Xiongjie2 　　1. Medical College of Nanhua University, Hu′nan Province, Hengyang 421001, China; 2. Hunan Peoples Hospital, Hu′nan Province, Changsha 410005, China 　　[Abstract] Objective To evaluate the clinical efficacy differences of anterior and posterior debridement in the treatment of lumbar vertebral tuberculosis and provide useful basis for clinical treatment. Methods 62 patients with lumbar vertebral tuberculosis were randomly divided into the anterior group (31 cases) and the posterior group (31 casess). The elective debridement and grafting fusion and internal fixation surgery was performed. The surgery time, amount of blood loss, length of hospital stay, ESR, cobb angle, bone fusion and postoperative recurrence and other conditions 1 month and 3 months after surgery of the two groups were compared. Results The amount of blood loss, ESR 3 months after surgery, and cobb angle and number of recurrence 12 months after surgery of the anterior group were superior to the posterior group, differences were all statistically significant (all P 0.05). Conclusion There are corresponding indications in the anterior and posterior clinical treatment of lumbar vertebral tuberculosis, but the anterior debridement, compared with the posterior debridement, has less blood loss, smaller correction angel loss, faster grafting fusion, lower recurrence rate and other characteristic