發(fā)布時(shí)間：2018-01-22 06:43

  本文關(guān)鍵詞： 同種異體骨 脊柱結(jié)核 前路內(nèi)固定　出處：《第三軍醫(yī)大學(xué)學(xué)報(bào)》2015年12期 　論文類型：期刊論文

【摘要】：目的探討經(jīng)前路一期病灶清除椎間植骨融合內(nèi)固定手術(shù)對(duì)脊柱結(jié)核患者的治療效果,評(píng)價(jià)同種異體髂骨塊的安全性和有效性。方法回顧性分析2008年1月至2012年12月在我科診斷為脊柱結(jié)核患者病例資料,嚴(yán)格按手術(shù)指征篩選出適合采用經(jīng)前路一期病灶清除椎間植骨融合內(nèi)固定手術(shù)的患者共60例,植骨材料選擇同種異體髂骨塊。術(shù)后繼續(xù)標(biāo)準(zhǔn)化抗結(jié)核化療方案12~18個(gè)月,同時(shí)佩戴支具3~6個(gè)月;隨訪9~36(22.80±7.71)個(gè)月,定期復(fù)查CRP、ESR,監(jiān)測(cè)肝腎功;觀察X線、CT、MRI等影像學(xué)改變。根據(jù)手術(shù)前后及末次隨訪影像學(xué)資料分析畸形矯正度數(shù)和植骨融合情況。結(jié)果所有患者均未出現(xiàn)脊髓血管損傷感染等并發(fā)癥,切口均一期愈合。根據(jù)Bridwell標(biāo)準(zhǔn),骨融合時(shí)間9個(gè)月至1年,達(dá)到Ⅰ級(jí)骨性融合標(biāo)準(zhǔn)56例,Ⅱ級(jí)骨性融合標(biāo)準(zhǔn)4例。術(shù)后半年內(nèi)血沉逐漸恢復(fù),末次隨訪ESR均在正常范圍(0~20 mm/h);術(shù)后融合節(jié)段Cobb’s角丟失2.38°±1.86°。結(jié)論在有效的抗結(jié)核化療基礎(chǔ)上,通過一期前路病灶清除椎間植骨融合內(nèi)固定手術(shù),應(yīng)用同種異體髂骨塊作為椎間植骨材料,可擺脫供骨區(qū)并發(fā)癥困擾,有效矯正后凸畸形、重建脊柱穩(wěn)定性。
[Abstract]:Objective to evaluate the effect of anterior debridement and intervertebral fusion and internal fixation in the treatment of spinal tuberculosis. Methods the data of patients with spinal tuberculosis diagnosed in our department from January 2008 to December 2012 were retrospectively analyzed. A total of 60 patients were selected according to the surgical indications who were suitable for anterior debridement, intervertebral fusion and internal fixation. The bone graft materials were selected as allograft iliac bone graft. After operation, standardized anti-tuberculosis chemotherapy regimen was continued for 12 ~ 18 months, and the brace was worn for 3 ~ 6 months. The patients were followed up for a period of 9 months from 36 days to 22.80 鹵7.71 months, and the CRP ESRs were checked regularly to monitor the liver and kidney function. X ray CT was observed. MRI and other imaging changes. According to the imaging data before and after operation and the last follow-up, the degree of correction of malformation and bone graft fusion were analyzed. Results none of the patients had complications such as spinal cord vascular injury infection. According to Bridwell standard, bone fusion time was 9 months to 1 year, 56 cases were grade 鈪，

本文編號(hào)：1453980