本文關(guān)鍵詞： 結(jié)核 脊柱 兒童 后凸畸形 癱瘓　出處：《中國脊柱脊髓雜志》2015年03期 　論文類型：期刊論文

【摘要】：目的:總結(jié)少兒脊柱結(jié)核的臨床特點(diǎn),為其診斷和治療提供參考。方法:對2006年1月~2012年12月我院收治的112例少年兒童脊柱結(jié)核患者歸納分析其首診原因、病程、受累節(jié)段、受累椎體數(shù)、后凸Cobb角、癱瘓情況,并分析病程、受累椎體數(shù)和后凸Cobb角之間的相關(guān)性,同時根據(jù)年齡將患者分成嬰幼兒(0~3歲)、學(xué)齡前兒童(4~6歲)、學(xué)齡兒童(7~12歲)、少年(13~17歲)四組并進(jìn)行比較。將脊柱分為脊柱上段(頸段、頸胸段、胸段)和脊柱下段(胸腰段、腰段、腰骶段和骶段)并對其所占的比例進(jìn)行比較。根據(jù)脊髓神經(jīng)功能將患者分為癱瘓組和非癱瘓組,比較兩組的病程、受累椎體數(shù)和后凸Cobb角。根據(jù)后凸Cobb角,以30°為界分為兩組,比較其癱瘓發(fā)生率。結(jié)果:少兒脊柱結(jié)核最常見首診原因?yàn)樘弁?病程平均5.3±10.9個月(1.5~72個月),受累椎體數(shù)平均2.9±1.0個(1~6個),累及胸椎最為常見。后凸Cobb角平均15.7°±17.0°(0~90.5°),后凸Cobb角、受累椎體數(shù)、病程之間有相關(guān)性(r為0.384~0.666,P0.05)。癱瘓組的Cobb角角度、受累椎體數(shù)和病程均顯著大于非癱瘓組(P0.05);Cobb角≥30°組發(fā)生癱瘓的比率(11/18,61.1%)明顯高于Cobb角30°組(12/70,17.1%)。比較四個年齡組的患者,疼痛和癱瘓在首診原因中所占的比率具有顯著性差異(X~2=32.695,P0.05);癱瘓發(fā)生率具有顯著性差異,嬰幼兒組(8/19,42.1%)和學(xué)齡前兒童組(8/31,25.8%)發(fā)生癱瘓的比率明顯高于學(xué)齡兒童組(4/39,10.3%)和少年組(3/23,13.0%)。四個年齡組患者的病程、脊柱上段和脊柱下段的發(fā)病率、受累椎體數(shù)、后凸Cobb角無顯著性差異(P0.05)。結(jié)論:少兒脊柱結(jié)核以疼痛首診和病變累及胸椎最為常見,其后凸Cobb角、受累椎體數(shù)和病程之間具有相關(guān)性。少兒脊柱結(jié)核中癱瘓患者的后凸Cobb角、受累椎體數(shù)和病程均顯著大于非癱瘓患者。幼兒和學(xué)齡前兒童以及后凸Cobb角≥30°者發(fā)生癱瘓的幾率較高。
[Abstract]:Objective: to summarize the clinical features of spinal tuberculosis in children, and to provide reference for the diagnosis and treatment of spinal tuberculosis in children. Methods: from January 2006 to December 2012, 112 children with spinal tuberculosis were treated in our hospital. The number of involved vertebrae, kyphosis Cobb angle, paralysis, and the correlation between the course of disease, the number of involved vertebrae and the Cobb angle of kyphosis were analyzed. At the same time, the patients were divided into four groups according to their age. The spinal column was divided into four groups: the upper part of the spine (neck segment, thoracic segment, thoracic segment) and the lower part of the spine (thoracolumbar segment). According to the neurological function of spinal cord, the patients were divided into paralyzed group and non-paralyzed group. The course of disease, the number of involved vertebrae and the Cobb angle of kyphosis were compared between the two groups. Results: pain was the most common cause of spinal tuberculosis in children. The average course of disease was 5.3 鹵10.9 months, the average number of involved vertebrae was 2.9 鹵1.0, the average number of involved vertebrae was 1 ~ 6, and the thoracic vertebrae was the most common. The average Cobb angle of kyphosis was 15.7 擄鹵17.0 擄0 ~ 90.5 擄, the Cobb angle of kyphosis, the number of involved vertebrae, and the course of disease were correlated r = 0.3840.666P0.05, respectively. The number of involved vertebrae and the course of disease were significantly higher than those in the non-paralyzed group (P 0.05 Cobb angle 鈮，

本文編號：1516803