单纯前路与一期前后路联合在腰椎结核患者中的疗效对比

发布时间：2018-03-07 04:25

本文选题：单纯　切入点：前路　出处：《青海大学》2015年硕士论文　论文类型：学位论文

【摘要】：目的:通过比较单纯前路病灶清除植骨融合内固定术与一期前后路联合手术的手术效果,探讨这两种手术方式在治疗腰椎结核中的临床疗效,从而为腰椎结核术式的选择提供参考。方法:系统性地回顾自2012年1月至2013年12月期间,在青海省人民医院接受手术治疗的118例腰椎结核患者,其中采用单纯前路病灶清除植骨融合内固定术的患者57例,采用一期前后路联合手术的患者61例,通过随机方法从两种手术方式中各抽取40例患者,分为A组(单纯前路病灶清除植骨融合内固定术组)与B组(一期前后路联合手术组),应用统计学方法对比分析术中出血量、手术时间、住院天数、神经功能、血沉及Cobb角等指标的变化情况。结果:术中出血量A组平均为473.6±114.2ml、B组为745.2±112.5ml,手术时间A组平均为145.2±21.4min、B组平均为227.4±48.3min,平均住院天数A组为17.4±5.2d、B组为22.5±4.7d,术前有功能障碍者A组30例、B组33例,经手术治疗后,A组改善27例、B组改善31例,血沉A组由术前的35.6±15.2mm/h到术后的44.1±22.6mm/h、B组由术前的31.9±16.8mm/h到术后的52.6±23.9mm/h,Cobb角A组由术前35.2±11.5°到术后的19.6±13.3°、B组由术前37.2±11.3°到术后的11.6±6.4°。组间分析A组与B组在术中出血量、手术时间、住院天数、Cobb角矫正方面均有统计学差异(P0.05),但血沉术前与术后的变化情况无统计学差异(P0.05),组内分析血沉术前与术后变化具有统计学差异(P0.05)。结论:单纯前路病灶清除植骨融合内固定术与一期前后路联合手术均能有效清除病灶,矫正畸形,但一期前后路联合手术在矫正后凸畸形,防止术后Cobb角的丢失方面具有优势。
[Abstract]:Objective: to compare the effect of anterior focus debridement and fusion internal fixation with one stage anterior and posterior approach in the treatment of lumbar tuberculosis. Methods: from January 2012 to December 2013, 118 patients with lumbar tuberculosis underwent surgical treatment in Qinghai Provincial people's Hospital. Among them, 57 cases were treated with anterior focus debridement, fusion and internal fixation, and 61 cases were treated by one-stage anterior and posterior approach. 40 patients were randomly selected from each of the two methods. The patients were divided into two groups: group A (simple anterior focus debridement, fusion and internal fixation) and group B (group B). Blood loss, operative time, hospital stay, nerve function were analyzed by statistical method. Results: the average amount of blood loss in group A was 473.6 卤114.2 ml / ml group (745.2 卤112.5 ml), the average time of operation in group A was 145.2 卤21.4 min / min, the average duration of hospitalization was 227.4 卤48.3 min, and the average days of hospitalization in group A was 17.4 卤5.2dB (22.5 卤4.7 days). After surgical treatment, there were 27 cases of improvement in group A and 31 cases in group B. ESR group A ranged from 35.6 卤15.2 mm / h before operation to 44.1 卤22.6 mm / h after operation from 31.9 卤16.8 mm / h before operation to 52.6 卤23.9mm / h after operation in group A from 35.2 卤11.5 掳preoperatively to 19.6 卤13.3 掳B after operation from 37.2 卤11.3 掳preoperatively to 11.6 卤6.4 掳postoperatively. There were significant differences in the number of days in hospital and the correction of Cobb angle, but there was no significant difference in the changes of ESR before and after operation (P 0.05). There was a statistical difference between preoperative and postoperative changes of ESR in group A and P 0.05.Conclusion: simple anterior approach focus debridement is a significant difference. Bone graft fusion and internal fixation combined with one-stage anterior and posterior approach can effectively clear the lesions. Correction of deformities, but one-stage anterior-posterior approach combined with surgery in correction of kyphosis, to prevent the loss of postoperative Cobb angle has an advantage.
【学位授予单位】：青海大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R687.3

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