化疗联合手术治疗腰椎结核疗效观察

目的：探讨化疗联合手术治疗脊柱结核的临床疗效.方法：采用术前及术后抗结核药物化疗联合手术治疗2000年1月～2008年1月收治的115例脊柱结核患者,比较治疗前后血沉、影像学检查等差异.结果：115例腰椎结核患者经1个月以上术前抗结核化疗后,结核中毒症状均有不同程度的改善,术后切口均为一期愈合,无窦道形成.术后2个月时所有患者结核中毒症状及病变腰椎疼痛消失,ESR恢复正常时间为2 ～6周,平均2.3周.合并神经功能损害中有Frankel A级以上改善19例（86.4%）.病灶清除＋植骨融合术术后1年植骨融合率71.9%（23/32）,术后2年植骨融合率90.6%（29/32）.术后并发神经根损伤4例、脊髓损伤1例、硬膜撕裂2例、脑脊液漏2例,结核病灶治愈率为95.6%.结论：术前及术后标准化抗结核化疗联合手术治疗腰椎结核是安全有效的,术后并发症少,结核病灶治愈率高.

The chemotherapy union surgery treats lumbar vertebra tuberculosis curative effect observation

Objective： The discussion chemotherapy union surgery treats the tuberculosis the clinical curative effect. Methods： After uses in front of the technique and the technique the anti--tuberculosis medicine chemotherapy union surgery treats 115 example tuberculosis pa- tient who in January, 2000 - 2008 years in January admitted, compared with treatment around erythrocyte sedimentation rate, differences and so on phantom study inspection. Results：] 15 example lumbar vertebra tuberculosis patient after 1 month in front of the technique the anti-- tuberculosis chemotherapy, the tuberculosis poison symptom has the varying degree improvement, after the technique the margin is an issue heals, does not have the Dou road to form. Technique latter 2 months all patient tuberculosis poison symptom and pathological change lumbar vertebra ache vanishing, ESR restores the normal time is 2- 6 weeks, the average 2.3 weeks. In the merge nerve function harm has Frankel above the A level to improve 19 examples （86.4%）. The focus of infection eliminates ＋ plants the bone fusion technique technique latter 1 year to plant the bone fusion rate 71.9 % （23/32）, the technique latter 2 years plant the bone fusion rate 90.6 % （29/32）. After the technique the concurrent nerve root damages 4 examples, the spinal cord damages ] example, the hard membrane rends 2 examples, the cerebrospinal fluid leaks 2 examples, the tuberculosis focus of infection cure rate is 95.6 %. Conclusion： In front of after the technique and the technique the standardized anti-tuberculosis chemotherapy union surgery treats the lumbar vertebra tuberculosis is safe effective,after the technique the complication are few,tuberculosis focus of infection cure rate high.