腹膜后腔镜辅助下小切口结核病灶清除、植骨融合术治疗腰椎结核疗效分析

发布时间：2018-05-12 07:06

本文选题：腰椎结核 + 腹腔镜　；参考：《福建医科大学》2013年硕士论文

【摘要】：目的：探讨腹膜后腔镜辅助下小切口结核病灶清除、植骨融合术治疗腰椎结核疗效。方法：回顾性分析我科从2006年1月～2012年1月期间治疗脊柱结核患者，其中采用腹膜后腔镜辅助下小切口结核病灶清除、植骨融合术治疗腰椎结核患者随访获得完整资料12例。其中男性9例，女性3例；年龄20-74岁，平均46.83岁。病变节段：L1-L22例、L2-L35例、L3-L44例、L4-L51例。神经功能受损4例，ASIA分级C级1例，D级3例。术前经X线CT及MRI诊断为脊柱结核，术后病理检查确诊。术前术后依据神经功能进行神经功能评分。持续抗结核治疗9~12个月。按术后1个月，3个月，6个月，1年，2年随访实验室检查和影像学检查结果。结果：随访12到48个月，平均24．14±9．65个月。手术时间平均2.90±0.50h，术中平均出血260.52±54.96ml，无术中并发症。4例术前神经功能受损患者术后神经功能完全恢复正常，，ASIA分级均为E级。术前Cobb角平均为(20.21±6.18)°,术后平均Cobb角为(11.43±4.20)°，后凸畸形矫正情况P0.01,有统计学意义，末次随访平均角度丢失(2.73±1.82)°。术后6个月时骨性融合率为60%，2年时融合100%。所有末次随访均未见结核复发。结论：腹膜后腔镜辅助下小切口结核病灶清除、植骨融合术治疗腰椎结核近期疗效良好。
[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 卤9.65 months). The average operative time was 2.90 卤0.50 h, the average intraoperative bleeding was 260.52 卤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 卤6.18 掳, and the postoperative Cobb angle was 11.43 卤4.20 掳. The correction of kyphosis was significant (P 0.01). The average angle loss was 2.73 卤1.82 掳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.
【学位授予单位】：福建医科大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R529.2

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