脊柱结核术后复发危险因素的分析

目的：探讨脊柱结核术后复发的危险因素。方法：将1995年1月～2005年1月脊柱结核术后复发的59例患者临床资料与同期术后未复发的216例脊柱结核患者的资料对比，应用Logistic回归分析比较两组患者的年龄、性别、自身营养状况、合并脊柱外结核情况、病灶范围、手术清除病灶是否彻底、手术前及手术后是否正规化疗、手术后病灶部位是否严格制动、术前是否存在其它合并症、术后是否存在其它并发症与术后脊柱结核复发的相关强度．推测可能导致术后脊柱结核复发的危险因素。结果：手术前及手术后不能坚持正规化疗、手术后病灶部位未严格制动、手术清除病灶不彻底、自身营养不良、病灶范围广5个因素与术后脊柱结核复发有显著相关性（P〈0．05）。结论：术前及术后正规化疗、加强营养、术中病灶清除彻底、术后病灶部位严格制动是预防和减少脊柱结核术后复发的关键。

Study on the risk factors associated with postoperative recurrence of spinal tuberculosis

Objective:To analyze the risk factors associated with postoperative recurrence of spinal tuberculosis.Method:From January 1995 to January 2005,59 patients with postoperative recurrence of spinal tuberculosis and 216 with no recurrence of spinal tuberculosis were studied retrospectively.Age,sex,nutritional status,complicated spinal lesion and range of lesion,debridement of lesion,preoperational normal chemotherapy or not,strict immobilization after operation or not,complicated with other preoperational or postoperative complications or not between two groups were compared by Logistic regression analysis.Result:The risk factors associated with postoperative recurrence of spinal tuberculosis included not having normal preoperational chemotherapy,not having strict immobilization after operation,not having complete resection of involved site,bad nutrition and large range of lesion(P<0.05). Conclusion:Normal preoperational chemotherapy,good nutritional status,imtraoperative complete resection of involved site and strict immobilization after operation should be helpful to prevent and reduce postoperative recurrent rate of spinal tuberculosis.