少儿脊柱结核的临床特点分析

发布时间：2018-02-17 00:35

  本文关键词： 结核 脊柱 儿童 后凸畸形 瘫痪　出处：《中国脊柱脊髓杂志》2015年03期 　论文类型：期刊论文

【摘要】：目的:总结少儿脊柱结核的临床特点,为其诊断和治疗提供参考。方法:对2006年1月~2012年12月我院收治的112例少年儿童脊柱结核患者归纳分析其首诊原因、病程、受累节段、受累椎体数、后凸Cobb角、瘫痪情况,并分析病程、受累椎体数和后凸Cobb角之间的相关性,同时根据年龄将患者分成婴幼儿(0~3岁)、学龄前儿童(4~6岁)、学龄儿童(7~12岁)、少年(13~17岁)四组并进行比较。将脊柱分为脊柱上段(颈段、颈胸段、胸段)和脊柱下段(胸腰段、腰段、腰骶段和骶段)并对其所占的比例进行比较。根据脊髓神经功能将患者分为瘫痪组和非瘫痪组,比较两组的病程、受累椎体数和后凸Cobb角。根据后凸Cobb角,以30°为界分为两组,比较其瘫痪发生率。结果:少儿脊柱结核最常见首诊原因为疼痛,病程平均5.3±10.9个月(1.5~72个月),受累椎体数平均2.9±1.0个(1~6个),累及胸椎最为常见。后凸Cobb角平均15.7°±17.0°(0~90.5°),后凸Cobb角、受累椎体数、病程之间有相关性(r为0.384~0.666,P0.05)。瘫痪组的Cobb角角度、受累椎体数和病程均显著大于非瘫痪组(P0.05);Cobb角≥30°组发生瘫痪的比率(11/18,61.1%)明显高于Cobb角30°组(12/70,17.1%)。比较四个年龄组的患者,疼痛和瘫痪在首诊原因中所占的比率具有显著性差异(X~2=32.695,P0.05);瘫痪发生率具有显著性差异,婴幼儿组(8/19,42.1%)和学龄前儿童组(8/31,25.8%)发生瘫痪的比率明显高于学龄儿童组(4/39,10.3%)和少年组(3/23,13.0%)。四个年龄组患者的病程、脊柱上段和脊柱下段的发病率、受累椎体数、后凸Cobb角无显著性差异(P0.05)。结论:少儿脊柱结核以疼痛首诊和病变累及胸椎最为常见,其后凸Cobb角、受累椎体数和病程之间具有相关性。少儿脊柱结核中瘫痪患者的后凸Cobb角、受累椎体数和病程均显著大于非瘫痪患者。幼儿和学龄前儿童以及后凸Cobb角≥30°者发生瘫痪的几率较高。
[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 卤10.9 months, the average number of involved vertebrae was 2.9 卤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 掳卤17.0 掳0 ~ 90.5 掳, 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，

本文编号：1516803