| 颈椎结核耐药性观察及个体化治疗 |
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| 引用本文： | 陈兴,鲍达,马远征,郭立新,李洪敏,黄凤山. 颈椎结核耐药性观察及个体化治疗[J]. 脊柱外科杂志, 2008, 6(5): 284-287 |
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| 作者姓名： | 陈兴 鲍达 马远征 郭立新 李洪敏 黄凤山 |
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| 作者单位： | 解放军总医院第二附属医院骨科,北京,100091;全军结核病研究所;内蒙古自治区赤峰宝山医院骨科 |
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| 摘 要： | 目的观察颈椎结核分枝杆菌（M.TB）耐药情况;探讨颈椎结核个体化治疗方案。方法2002年1月-2006年12月,行前路病灶清除植骨内固定手术治疗且随访1年以上的颈椎结核病例31例,均在术中取得脓液标本并经病理检查证实为颈椎结核。检测M.TB分离株对14种抗结核药的敏感性;PCR-SSCP法检测M.TB分离株耐药基因突变。术后不耐药者化疗6-9个月,耐单药者化疗12个月,耐多药者化疗18个月。随访时间为1-5年,平均3.2年。结果总耐药率为54.8%,耐多药率为25.8%;在M.TB耐药株中,5种耐药基因（katG,rpoB,rpsL,embB,pncA）突变率为88.1%;M.TB敏感株未检出耐药基因突变。本组切口一期愈合率为93.5%,总治愈率为96.8%。结论颈椎M.TB产生耐药性与相应的基因突变密切相关。在个体化有效抗痨的基础上,应用病灶清除减压一期植骨内固定治疗颈椎结核,临床疗效满意。
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| 关 键 词： | 颈椎 结核 脊柱 抗多种药物性 内固定器 脊柱融合术 |
| 收稿时间： | 2007-12-03 |
Drug resistance observation and individualized treatment of cervical spinal tuberculosis |
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| CHEN Xing,BAO D,MA Yuanzheng,GUO Lixin,LI Hongmin and HUANG Fengshan. Drug resistance observation and individualized treatment of cervical spinal tuberculosis[J]. Journal of Spinal Surgery, 2008, 6(5): 284-287 |
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| Authors: | CHEN Xing BAO D MA Yuanzheng GUO Lixin LI Hongmin HUANG Fengshan |
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| Affiliation: | CHEN Xing,BAO Da,MA Yuanzheng,GUO Lixin,LI Hongmin,HUANG Fengshan.Department of Orthopaedics,Second Affiliated Hospital,PLA General Hospital,Beijing 100091,China |
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| Abstract: | Objective To observe the drug resistance of mycobacterium tuberculosis(M.TB),and to discuss the individualized treatment of cervical spinal tuberculosis.Methods Thirty-one cases of cervical spinal tuberculosis treated with anterior radical debridement,decompression and inter fixation from January 2002 to December 2006 were included(at least 1 year follow-up).Liquor puris were got in the operation and were confirmed by pathology.The sensitive of M.TB example for 14 kinds of antituberculotic were detected.And... |
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| Keywords: | Cervical vertebrae Tuberculosis spinal multidrug-resistant Internal fixators Spinal fusion |
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