邻近多节段脊柱结核的手术入路选择及疗效分析

发布时间：2018-05-16 06:12

本文选题：邻近多节段脊柱结核 + 手术入路　；参考：《新疆医科大学》2017年硕士论文

【摘要】：目的:回顾性分析前路,后路及联合后前路三种手术患者术前,术后的相关指标来评估三种手术的疗效,总结邻近多节段脊柱结核不同术式相关并发症并探索邻近多节段脊柱结核的最佳手术入路。方法:回顾性分析新疆医科大学第一附属医院2011年12月至2016年12月收治取得随访的41例邻近多节段脊柱结核患者的临床资料。通过收集有关前路组(A组),后路组(B组)及联合后前路组(C组)患者神经功能改善程度,术前术后ESR、CRP改变,后凸角改变,骨融合情况,并发症等资料并进行统计学分析来评估三种手术方式临床疗效。结果:三组组内患者的术前,术后ESR、CRP、后凸角改变,神经功能改善情况有统计学意义(p0.05)。术后并发症主要有术区感染、脑脊液漏、结核复发、内固定失败、营养不良等,给予相应处理后好转。结论:各自的适应症范围内前路组(A组),后路组(B组)及联合后前路组(C组)三种手术方式对于治疗邻近多节段脊柱结核均有效,安全的方法,每种手术入路都有自己的最佳适应症,因此我们应该根据患者的一般情况,病灶特点,耐受程度,并发症类型,外科医生的技术及经验,患者的经济情况等方面综合考虑选择最佳的个体化手术方案。
[Abstract]:Objective: to evaluate the efficacy of anterior, posterior and combined anterior and posterior approaches. To summarize the complications associated with different surgical procedures for adjacent multi-segmental spinal tuberculosis and to explore the best approach for adjacent multi-segmental spinal tuberculosis. Methods: the clinical data of 41 patients with adjacent multi-level spinal tuberculosis admitted from December 2011 to December 2016 in the first affiliated Hospital of Xinjiang Medical University were retrospectively analyzed. The improvement degree of nerve function, the changes of ESR-CRP, kyphoid angle and bone fusion were collected in group A, group B and group C, respectively, before and after operation. Complications and other data were statistically analyzed to evaluate the clinical efficacy of the three surgical methods. Results: the preoperative and postoperative ESR-CRP, kyphoid angle changes, and the improvement of nerve function in the three groups were statistically significant (P 0.05). The main complications were infection of operation area, cerebrospinal fluid leakage, recurrence of tuberculosis, failure of internal fixation, malnutrition and so on. Conclusion: each of the three operative methods is effective and safe in the treatment of adjacent spinal tuberculosis, including group A (group A), group B (group B) and group C (combined with anterior approach). Each approach has its own best indication, so we should take into account the general condition of the patient, the characteristics of the lesion, the degree of tolerance, the type of complications, the skill and experience of the surgeon. The patient's economic condition and so on considered the best individual operation plan synthetically.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R687.3

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