發(fā)布時(shí)間：2018-12-11 18:57

【摘要】：目的:通過比較單純后路手術(shù)與前后路聯(lián)合手術(shù)治療脊柱結(jié)核患者的手術(shù)資料和術(shù)后隨訪資料,分析兩種手術(shù)的臨床療效,評(píng)價(jià)單純后路手術(shù)的有效性及安全性,為單純后路手術(shù)治療脊柱結(jié)核提供循證醫(yī)學(xué)證據(jù)。方法:回顧性分析2003年1月至2013年6月在南昌大學(xué)第一附屬醫(yī)院接受手術(shù)治療的脊柱結(jié)核患者。總共納入165例患者,單純后路手術(shù)組76例,前后路聯(lián)合手術(shù)組89例,其中男73例,女92例,單純后路手術(shù)組男37例,女39例,前后路聯(lián)合手術(shù)組男36例,女53例。比較兩組患者術(shù)前、術(shù)后及末次隨訪的VAS評(píng)分、JOA評(píng)分、術(shù)后住院時(shí)間、住院費(fèi)用(除器械費(fèi)用外)、手術(shù)時(shí)間、術(shù)中出血量、術(shù)后植骨融合時(shí)間、并發(fā)癥發(fā)生例數(shù),以及局部后凸Cobb角變化,隨訪方式為出院后第3、6、9、24個(gè)自然月到我院門診或住院部進(jìn)行常規(guī)隨訪。結(jié)果:單純后路手術(shù)組在手術(shù)時(shí)間、術(shù)中出血量、術(shù)后住院時(shí)間、術(shù)后JOA評(píng)分、以及后凸Cobb角的矯正率上均優(yōu)于前后路聯(lián)合手術(shù)組,而植骨融合時(shí)間、術(shù)后并發(fā)癥例數(shù)、末次隨訪JOA評(píng)分、出院時(shí)和末次隨訪VAS評(píng)分兩者相比無統(tǒng)計(jì)學(xué)差別。結(jié)論:單純后路手術(shù)較前后路聯(lián)合手術(shù)療效更確切、安全,是治療脊柱結(jié)核的合理選擇,具有重要的臨床應(yīng)用價(jià)值。
[Abstract]:Objective: to evaluate the efficacy and safety of posterior and posterior approaches in the treatment of spinal tuberculosis by comparing the surgical data and follow-up data of patients with spinal tuberculosis. To provide evidence-based medical evidence for the treatment of spinal tuberculosis by posterior approach alone. Methods: from January 2003 to June 2013, patients with spinal tuberculosis undergoing surgical treatment in the first affiliated Hospital of Nanchang University were analyzed retrospectively. A total of 165 patients were included in the study, 76 cases in the posterior approach group and 89 cases in the combined anterior and posterior approach group, including 73 males and 92 females, 37 males, 39 females, 36 males and 53 females in the combined anterior and posterior approach group. The VAS score, JOA score, postoperative hospitalization time, hospitalization cost (other than equipment cost), operation time, intraoperative bleeding volume, postoperative bone graft fusion time, and the number of complications were compared between the two groups. And the change of Cobb angle of local kyphosis was followed up by routine follow up in outpatient department or inpatient department of our hospital in 24 months after discharge. Results: the postoperative time, blood loss, postoperative hospitalization time, postoperative JOA score and correction rate of kyphosis Cobb angle in the simple posterior approach group were better than those in the anterior and posterior approach combined operation group, but the time of bone graft fusion and postoperative complications were better than those in the anterior and posterior approach combined operation group. There was no significant difference between the JOA score at the last follow-up and the VAS score at the discharge and the last follow-up. Conclusion: simple posterior approach is more effective and safe than combined anterior and posterior surgery. It is a reasonable choice for the treatment of spinal tuberculosis and has important clinical application value.
【學(xué)位授予單位】：南昌大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R687.3

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