脊柱结核的初诊病分析与治疗

目的 提高对脊柱结核的认识，降低误诊率。方法 对我院2005～2011年52例脊柱结核误诊患者进行综合分析。结果 本组病例均有局部疼痛、压痛及叩击痛，来自农村小城镇38例占73.1%,有肺结核病史9例占17.3%，全身性中毒症状5例占9.6%，下肢痛和或麻木28例占53.8%，脊柱活动受限36例占69.2%，后凸畸形6例占11.5%，血沉升高45例占86.5%，X线片阳性征象34例占65.3%，CT/MR检查阳性征象49例占94.2%，误诊率为20.2%。结论 提高对脊柱结核的临床特点认识，重视体检和影像学表现，拓宽诊断思路，才能减少误诊率。

Analysis and treatment for first-visiting case of the spinal tuberculosis

To improve the understanding of spinal tuberculosis, and to reduce the rate of misdiagnosis. A comprehensive analysis was conducted for the 52 misdiagnosed cases of spinal tuberculosis in the hospital from 2005 to 2011. All patients complained of local pain, tenderness and percussion pain. Among them, 38 cases (73.1%) came from rural areas; 9 cases (17.3%) had history of pulmonary tuberculosis; 5 cases (9.6%) had tuberculotic toxic symptoms, 28 cases (53.8%) complained of lower limb pain and numbness, 36 cases (69.2%) of limited spinal activity; 6 cases (11.5%) had kyphosis. The erythrocyte sedimentation rate rose in 45 cases (86.5% ); the positive signs of the X-ray film were presented in 34 cases (65.3%); positive signs of CT / MR examination were found in 49 cases (94.2%). The misdiagnostic rate was 20.2%. The clinical features of spinal tuberculosis should receive due attention. An emphasis on the importance of physical examination and the imaging performance will help reduce the misdiagnostic rate.