中西医结合治疗胸腰椎结核78例

目的:探讨中西医结合治疗胸腰椎结核的方法和临床疗效。方法:对78例患者术前应用雷米封、利福平、乙胺丁醇三联抗痨2周,内服中药并纠正贫血及低蛋白血症。血沉恢复正常或连续观察低于50mm/h后进行前路病灶清除、一期髂骨植骨、钛钢板内固定,术后继续抗痨和口服中药治疗12～18个月。结果:3例胸椎、1例腰椎多椎体结核患者出现术后局部并发感染,经再次清创等处理后治愈;74例愈合良好。随访1.5～4.0年,植骨块5～7个月融合,无移位、折断和吸收。结论:前路病灶清除、一期髂骨植骨、钛钢板内固定结合中药治疗胸腰椎结核,具有矫正后凸畸形、稳定脊柱、并发症少、术后早期离床活动等优点。

Integrated Chinese and Western Medicine Treatment of Thoracolumner Spine Tuberculosis

Objective To evaluate the clinical results of thoracolumbar spine tuberculosis treated with integrated Chinese and Western medicine. Methods Seventy-eight patients with spinal tuberculosis were treated by anterior partial vertebrectomy, iliac grafting and fixation. Anti-tuberculosis drugs and Chinese herbal medicine were routinely administered before and after operation. Results All patients were followed up for 1.5～4 years （average 2.5 years）. Three patients with thoracic spinal and one with lumber spinal tuberculosis, who suffered from local infection were cured by debridement; the other 74 patients had wounds healed uneventfully after surgery. Bone fusion was achieved 5- 7 months after surgery. Conclusion Partial vertebrectomy with iliac grafting and internal fixation integrated with Chinese herbal medicine treatment is a safe and effective therapy for thoracolumber spine tuberculosis.