脓肿形成对布鲁杆菌性脊柱炎疗效的影响

发布时间：2019-06-15 12:39

【摘要】：目的：探讨脓肿形成对布鲁杆菌脊柱炎药物、手术疗效的影响。方法：2008年1月-2013年2月，共诊断出布鲁杆菌病146例，其中形成脊柱炎的患者共35例。根据核磁共振（Magnetic Resonance ImagingMRI）结果，将患者分为无脓肿组和脓肿形成组。评价患者治疗前后临床症状、影像学、实验室检查等相关指标变化。结果：在全部布鲁杆菌感染患者中，脊柱炎发生率为23.9%。感染脊柱的部位分布：颈椎（8.6%），胸椎（22.9%），腰椎（60%），骶椎（22.9%）。脓肿发生率为16（45.7%），伴明显贫血。药物治疗方案为链霉素（前3周），强力霉素，，利福平。治疗时间为20天-49月（6±7.45SD）月。经过12周的药物治疗，在无脓肿组临床症状改善（64.7%vs.30%）、影像学改善（88.2%vs.50%）要明显优于脓肿形成组。形成了脓肿的患者其药物治疗时间要更长。共8例患者接受了手术治疗。其中无脓肿形成组2例，脓肿形成组6例。结论：布鲁杆菌脊柱炎继发脓肿形成后，治疗的时间更长，更倾向于接受手术治疗。病灶清除、植骨、内固定手术对合并有脓肿的布鲁杆菌脊柱炎疗效确切。
[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 卤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.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R681.51;R516.7

【参考文献】