本文選題：腰椎結(jié)核 + 腹腔鏡��； 參考：《福建醫(yī)科大學(xué)》2013年碩士論文

【摘要】：目的： 探討腹膜后腔鏡輔助下小切口結(jié)核病灶清除、植骨融合術(shù)治療腰椎結(jié)核療效。 方法： 回顧性分析我科從2006年1月～2012年1月期間治療脊柱結(jié)核患者，其中采用腹膜后腔鏡輔助下小切口結(jié)核病灶清除、植骨融合術(shù)治療腰椎結(jié)核患者隨訪獲得完整資料12例。其中男性9例，女性3例；年齡20-74歲，平均46.83歲。病變節(jié)段：L1-L22例、L2-L35例、L3-L44例、L4-L51例。神經(jīng)功能受損4例，ASIA分級C級1例，D級3例。術(shù)前經(jīng)X線CT及MRI診斷為脊柱結(jié)核，術(shù)后病理檢查確診。術(shù)前術(shù)后依據(jù)神經(jīng)功能進行神經(jīng)功能評分。持續(xù)抗結(jié)核治療9~12個月。按術(shù)后1個月，3個月，6個月，1年，2年隨訪實驗室檢查和影像學(xué)檢查結(jié)果。 結(jié)果： 隨訪12到48個月，平均24．14±9．65個月。手術(shù)時間平均2.90±0.50h，術(shù)中平均出血260.52±54.96ml，無術(shù)中并發(fā)癥。4例術(shù)前神經(jīng)功能受損患者術(shù)后神經(jīng)功能完全恢復(fù)正常，，ASIA分級均為E級。術(shù)前Cobb角平均為(20.21±6.18)°,術(shù)后平均Cobb角為(11.43±4.20)°，后凸畸形矯正情況P0.01,有統(tǒng)計學(xué)意義，末次隨訪平均角度丟失(2.73±1.82)°。術(shù)后6個月時骨性融合率為60%，2年時融合100%。所有末次隨訪均未見結(jié)核復(fù)發(fā)。 結(jié)論： 腹膜后腔鏡輔助下小切口結(jié)核病灶清除、植骨融合術(shù)治療腰椎結(jié)核近期療效良好。
[Abstract]:Objective: To evaluate the efficacy of retroperitoneal endoscopy in the treatment of lumbar tuberculosis. Methods: From January 2006 to January 2012, 12 patients with spinal tuberculosis were treated with retroperitoneal endoscopy assisted with small incision removal of tuberculosis focus, and 12 patients with lumbar tuberculosis treated by bone grafting and fusion were followed up. There were 9 males and 3 females aged 20-74 with an average age of 46.83 years. There were 22 cases of L2-L35 cases of L3-L44 cases of L4-L51 cases. There were 4 cases with neurological dysfunction and 1 case with grade C of Asia grade and 3 cases with grade D. Spinal tuberculosis was diagnosed by X-ray CT and MRI before operation and confirmed by pathological examination after operation. Before and after operation, nerve function was evaluated according to nerve function. Continuous antituberculous therapy for 9 ~ 12 months. The results of laboratory and imaging examination were followed up 1 month, 3 months, 6 months, 1 year and 2 years after operation. Results: The follow-up was 12 to 48 months (mean 24.14 鹵9.65 months). The average operative time was 2.90 鹵0.50 h, the average intraoperative bleeding was 260.52 鹵54.96 ml. The neurological function of the patients with neurological impairment before and after operation was completely restored to grade E without intraoperative complications. The mean preoperative Cobb angle was 20.21 鹵6.18 擄, and the postoperative Cobb angle was 11.43 鹵4.20 擄. The correction of kyphosis was significant (P 0.01). The average angle loss was 2.73 鹵1.82 擄at the last follow-up. The osseous fusion rate was 60 at 6 months after operation and 100 at 2 years. No recurrence of tuberculosis was found at all the last follow-up. Conclusion: The treatment of lumbar tuberculosis by retroperitoneal endoscopy was satisfactory.
【學(xué)位授予單位】：福建醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2013
【分類號】：R529.2

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