微创手术与传统开放手术治疗脊柱结核的疗效比较

目的:探讨经皮病灶清除局部化疗治疗脊柱结核的临床疗效,并与开放手术病灶清除病例进行比较。方法:1993年1月~2001年12月应用开放手术病灶清除术治疗脊柱结核患者78例(A组),2002年1月~2003年10月应用经皮病灶清除局部化疗治疗脊柱结核患者36例(B组)。两组均无严重脊柱畸形和神经症状患者。对两组的手术时间、出血量、复发率等进行回顾性分析。结果:A组占同期所有脊柱结核住院患者的62.9%;B组占85.7%,高龄患者明显增加,同期没有施行单纯病灶清除术患者。两组患者的手术时间、出血量、局部化疗的时间、全身化疗的时间、手术复发率均有显著性差异(P<0.05)。结论:对未合并严重脊柱畸形和神经症状的脊柱结核患者采用经皮病灶清除局部化疗可取得满意的效果。

Treatment of spinal tuberculosis with focal debridement or percutaneous focal debridement and local chemotherapy

Objective: To compare the results of the treatment of spinal tuberculosis with focal debridement (group A) or percutaneous focal debridement and local chemotherapy(group B).Method:From Jan.1993 to Dec.2001,78 cases of spinal tuberculosis were treated with focal debridement.From Jan.2002 to Oct.2003,36 cases of the same disorders were treated with percutaneous focal debridement and local chemotherapy.No severe spinal deformity or neurological deficits were in all patients.After operation,the operative duration,hemorrhage,operative times,the time of general chemotherapy and local chemotherapy,recurrent rate and et al were observed.Result:At first period,62.9% cases were in group A.At second period,85.7% cases were in group B.The operative times,hemorrhage,recurrence rate,local chemotherapy and general chemotherapy between two groups was significantly different.Conclusion:Percutaneous focal debridement and local chemotherapy can replace the status of focal debridement and be as main choice to treat spinal tuberculosis.It is apropriate for cases of spinal tuberculosis with no severe spinal deformity and nerve deficit.