晚期脊柱结核患者手术治疗和保守治疗临床分析.docVIP

晚期脊柱结核患者手术治疗和保守治疗临床分析 　　【摘要】 目的：分析比较手术治疗和保守治疗用于晚期脊柱结核患者的临床疗效。方法：选取2011年7月-2014年2月于本院诊治的68例晚期脊柱结核患者，根据患者自主选择治疗方法分为手术治疗组（n=45）和保守治疗组（n=23）。分析比较两组治疗有效率、不良反应发生率和患者治疗前后脊柱损伤协会ASIA神经功能分级评分。结果：手术治疗组45例患者中12例采用经前路病灶清除、植骨融合并前路内固定术，26例采用经后路病灶清除、植骨融合并后路内固定术，7例采用后路内固定并前路病灶切除、植骨融合术。治疗后两组患者ASIA评分均高于治疗前，治疗后手术治疗组患者的ASIA评分高于保守治疗组，比较差异均有统计学意义（P0.05）；手术治疗组治疗有效率大于治疗组，不良反应发生率小于保守治疗组，比较差异有统计学意义（P0.05）。结论：手术治疗晚期脊柱结核患者疗效显著，安全性高，值得临床推广使用。 　　【关键词】 手术治疗； 保守治疗； 晚期脊柱结核； 临床疗效 　　【Abstract】 Objective：To analyze and compare the clinical efficacy of surgical treatment and conservative treatment for patients with advanced spinal tuberculosis.Method：From July 2011 to February 2014，68 patients in our hospital with advanced spinal tuberculosis were randomly divided into two groups，according to the different treatment methods，45 patients were divided into surgical treatment group and 23 patients with conservative treatment group.The treatment efficiency，adverse effects rate and before and after treatment in patients with spinal cord injury association ASIA score of two groups were compared and analyzed.Result：Surgery in the treatment group with 12 cases used the anterior lesion clearance，bone graft fusion and anterior internal fixation；26 cases by posterior approach focus clearance， bone graft fusion and posterior internal fixation；7 cases used with posterior internal fixation and anterior resection resection and bone graft fusion.After treatment，the ASIA score of two groups were higher than before treatment.The ASIA score of surgical treatment group was higher than the conservative treatment group，the treatment efficiency was greater than the treatment group，the incidence of adverse reaction was less than the conservative treatment group，the differences were statistically significant（P0.05）.Conclusion：The curative effect of surgical treatment of patients with advanced spinal tuberculosis is significant and high security，it is worthy of clinical application. 　　【Key words】 Surgical treatment； Conserva