经皮穿刺局部化疗治疗老年性脊柱结核

[目的]研究CT引导下经皮穿刺局部化疗治疗老年性脊柱结核的疗效.[方法]23例60岁以上的老年性脊柱结核患者,19例行CT引导下经皮病灶清除局部化疗;4例行病灶切除,内固定治疗.[结果]所有患者平均卧床3～6个月,没有交叉感染、窦道形成和复发.21例患者恢复生活自理.1例Frankel D级局部化疗的患者1个月后发现症状和体征加重,改为手术治疗,术后瘫痪不全恢复.[结论]老年脊柱结核患者多数合并其他系统疾病,无法耐受切开手术.经皮穿刺局部化疗创伤小、花费少、疗效好,大多数患者可以恢复患病前的日常生活状态.

Treatment of spinal tuberculosis in old people with percutaneous puncture and local chemotherapy

Objective To investigate the result for treatment of spinal tuberculosis in old people with percutaneous puncture and local chemotherapy.Method Among 23 patients,19 patients were treated with percutaneous puncture and local chemotherapy,4 recerved focus debridement and internal fixation.Result No patient required readmission to hospital for the reason of reactivation of the disease.No complication was found.Twenty-one patients returned to home environment and normal daily lives.Activities of 2 patients over 70 years were limited because of senility and other system diseases.Paralysis was found in 1 case and debridement was received 1 month later.Conclusion Percutaneous puncture and local chemotherapy has advantages such as:less postoperative immobilization;less operative danger;less medical expenses.Most patients return to their normal daily lives.It is a recommendable method for the treating of spinal tuberculosis in old people.