全身化疗配合CT定位椎旁局部治疗脊柱结核的疗效观察

目的探讨全身化疗配合 CT 定位椎旁抽脓及局部注药治疗脊柱结核的疗效。方法回顾性分析1290例脊柱结核的临床资料，所有患者采用全身抗结核治疗18个月，结合 CT定位椎旁抽脓及局部注药治疗时间（55＆#177;14）d；其中310例患者有脊柱手术指征，在全身抗结核治疗结合CT定位椎旁抽脓及局部注药治疗2~4周后行病灶清除术。结果980例脊柱结核患者未发生交叉感染及窦道形成，随访3~5年，均达到治愈及停药标准，另310例手术后达到治愈。结论全身化疗配合CT定位椎旁抽脓及局部注药治疗结合全身抗结核治疗，对不伴有严重脊髓损伤或严重脊柱后凸畸形的脊柱结核疗效满意，值得临床推广。

Observation on the Efficacy of CT-guided Para-vertebral Local Therapy in the Treatment of Spinal Tuberculosis

Obj ective]To explore the efficacy of CT-guided para-vertebral aspiration and local drug inj ection for the treatment of spinal tuberculosis.Methods]Clinical data of 1290 patients with spinal tuberculosis were an-alyzed retrospectively.Among them,980 patients received systemic anti-tuberculosis therapy for 18 months and CT-guided para-vertebral aspiration and local drug injection for 55＆#177;14 days,while 310 patients received systemic anti-tuberculosis therapy,CT-guided para-vertebral aspiration and local drug inj ection for 2~4 weeks,and then underwent spinal debridement.Results]No cross infection and sinus formation were found in 980 patients.The patients were followed up for 3~5 years and met the curative and drug withdrawal criteria.After surgery,310 pa-tients were cured.Conclusion]CT-guided para-vertebral aspiration and local drug inj ection combined with system-ic anti-tuberculosis therapy for the treatment of spinal tuberculosis without severe spinal inj ury or serious kyphosis has satisfactory effect.Therefore,it is worthy of clinical promotion.