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 112例脊柱结核病人在全身抗结核药物治疗的支持下，用局麻或氯胺酮全麻。小切口单纯行寒性脓肿清除术，清除脓液、干酪及肉芽组织，同时局部脓腔用大量生理盐水冲洗，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。脓肿能很好地清除干净，对脓肿毒性反应强、体质差不能耐受大手术、或骨性病灶破坏轻是一个较好的治疗方法，减小了手术风险及患者负担。

Mini-incision Abscess Debridement for Spinal Tuberculosis:An Analysis of 112 Cases

Objective To explore the procedure, efficacy and clinical significance of abscess drainage and debridement with mini-incision technique for spinal TB complicated with psoas abscess and gravity abscess. Method In support of antitubereulosis drugs, for 112 patients of spinal tuberculosis complicated with psoas abscess, the mini-incision abscess debridement alone were performed; the pus, cheese tissue and granulation tissue were eliminated, the cavity was washed with a great deal of normal saline, a draining tube was placed in the low abscess cavity after operation. Result After operation, the tuberculous toxic symptoms of patients were apparently improved. Of all cases, 102 patients were healed; 5 patients had post-operation effusion in abscess cavity; 3 patients were suffered from fistula and post-operation recurrence occurred in 2 patients and the second operation was performed. Conclusion Since the mini-incision, the duration of operation is short, the abscess can be eliminated thoroughly .Themini-incision abscess debridement alone is good for patients with severe toxic symptoms, or those who are in tolerant of major operation, or for those whose bony lesion is too light to be performed operation and besides,the operational risk as well as economic burden are alleviated.