小切口单纯脓肿清除治疗脊柱结核112例分析

目的：探讨小切口单纯脓肿清除引流术治疗脊柱结核合并腰大肌脓肿及流注脓肿的方法、疗效及其临床意义。方法：在全身抗结核药物治疗的支持下，对112例脊柱结核合并腰大肌脓肿的患者采用小切口单纯寒性脓肿清除术，清除脓液、干酪及肉芽组织，同时用大量生理盐水冲洗局部脓腔，术后低位放置脓腔引流管。结果：脓肿清除术后患者结核中毒症状明显好转，102例一期治愈，5例术后形成脓腔积液．3例术后瘘管形成．2例术后复发行第二次手术。结论：小切口单纯脓肿清除创伤小、手术时间短，脓肿清除干净．对结核毒性反应强、体质差不能耐受大手术或骨性病灶破坏轻的患者是一种较好的治疗方法。

Analysis of 112 cases of spinal tuberculosis treated by mini-incision abscess debridemen

Objective:To explore the methods,effect and clinical significance of abscess drainage and debridement with mini-incision technique in treating spinal tuberculosis accomplied by psoas abscess and gravity abscess.Method:Under the support of antituberculosis drugs,112 patients of spinal tuberculosis accomplied by psoas abscess,the mini-incision abscess debridement alone was performed;the pus,cheese tissue and granulation tissue were eliminated;the cavity was purged with a great deal of normal saline;a draining tube was placed in the low abscess cavity after operation.Result:After operation,the tuberculotic toxic symptoms were alleviated.Of all cases,102 were healed;5 had post-operation fluid accumulation in abscess cavity;3 were suffered from fistula;post-operation recurrence was found and the second operation was performed in 2 patients.Conclusion:With the advantage of mini-incision,short duration of operation,the abscess can be eliminated thoroughly.The method of mini-incision abscess debridement alone is good for patients with severe toxic symptoms,or those who cannot tolerate complicating operation,or those with bony lesion too small to perform operation.Operational risk as well as economic load are alleviated.