【摘要】：目的：探討膿腫形成對布魯桿菌脊柱炎藥物、手術(shù)療效的影響。 方法：2008年1月-2013年2月，共診斷出布魯桿菌病146例，其中形成脊柱炎的患者共35例。根據(jù)核磁共振（Magnetic Resonance ImagingMRI）結(jié)果，將患者分為無膿腫組和膿腫形成組。評價患者治療前后臨床癥狀、影像學(xué)、實驗室檢查等相關(guān)指標(biāo)變化。 結(jié)果：在全部布魯桿菌感染患者中，脊柱炎發(fā)生率為23.9%。感染脊柱的部位分布：頸椎（8.6%），胸椎（22.9%），腰椎（60%），骶椎（22.9%）。膿腫發(fā)生率為16（45.7%），伴明顯貧血。藥物治療方案為鏈霉素（前3周），強(qiáng)力霉素，，利福平。治療時間為20天-49月（6±7.45SD）月。經(jīng)過12周的藥物治療，在無膿腫組臨床癥狀改善（64.7%vs.30%）、影像學(xué)改善（88.2%vs.50%）要明顯優(yōu)于膿腫形成組。形成了膿腫的患者其藥物治療時間要更長。共8例患者接受了手術(shù)治療。其中無膿腫形成組2例，膿腫形成組6例。 結(jié)論：布魯桿菌脊柱炎繼發(fā)膿腫形成后，治療的時間更長，更傾向于接受手術(shù)治療。病灶清除、植骨、內(nèi)固定手術(shù)對合并有膿腫的布魯桿菌脊柱炎療效確切。
[Abstract]:Objective: to investigate the effect of abscess formation on brucellosis spondylitis. Methods: from January 2008 to February 2013, 146 cases of brucellosis were diagnosed, including 35 cases of spondylitis. According to the results of nuclear magnetic resonance (Magnetic Resonance ImagingMRI), the patients were divided into two groups: no abscess group and abscess formation group. To evaluate the changes of clinical symptoms, imaging, laboratory examination and other related indexes before and after treatment. Results: the incidence of spondylitis was 23.9% in all patients with brucellosis. The distribution of infected spine was cervical vertebrae (8.6%), thoracic vertebrae (22.9%), lumbar vertebrae (60%) and sacral vertebrae (22.9%). The incidence of abscess was 16 (45.7%), accompanied by obvious anemia. The drug treatment regimen was streptomycin (first 3 weeks), doxycycline and rifampicin. The treatment time was from 20 days to 49 months (6 鹵7.45SD) months. After 12 weeks of drug treatment, the clinical symptoms were improved (64.7% vs. 30%) and the imaging improvement (88.2% vs. 50%) in the non-abscess group was significantly better than that in the abscess formation group. Patients with abscess are treated with drugs for a longer period of time. A total of 8 patients were treated surgically. There were 2 cases in the non-abscess group and 6 cases in the abscess formation group. Conclusion: after the formation of secondary abscess of brucellosis spondylitis, the treatment time is longer and more inclined to receive surgical treatment. Debridement, bone grafting and internal fixation are effective in the treatment of brucellosis spondylitis with abscess.
【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R681.51;R516.7

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