经椎弓根入路自体髂骨与钛网加同种异体骨内固定治疗胸椎结核效果比较

发布时间：2018-06-20 05:20

本文选题：胸椎结核 + 经椎弓根入路　；参考：《山东医药》2017年02期

【摘要】：目的比较经椎弓根入路自体髂骨与钛网加同种异体骨内固定治疗胸椎结核的效果。方法 59例胸椎结核患者,接受经椎弓根入路自体髂骨内固定治疗33例(自体组),经椎弓根入路钛网加同种异体骨内固定治疗26例(异体组)。比较两组手术时间、术中出血量、术后引流量、住院时间,比较两组术前、术后即刻、术后9个月时的脊柱Cobb角,比较两组患者术后3、6、9个月时的脊柱植骨融合率、融合时间。结果自体组手术时间、术中出血量高于异体组(P均0.05);两组术后引流量、住院时间比较P均0.05。两组术后即刻、术后9个月时脊柱Cobb角均较术前降低(P均0.05),但两组组间比较差异均无统计学意义。两组术后3、6、9个月时的植骨融合率比较差异均无统计学意义;自体组植骨融合时间短于异体组(P0.05)。结论经椎弓根入路自体髂骨、钛网加同种异体骨内固定治疗胸椎结核效果相当,但前者较后者更有利于患者术后骨性融合。
[Abstract]:Objective to compare the effect of autologous iliac bone and titanium mesh combined with allogeneic bone fixation via pedicle approach in the treatment of thoracic spinal tuberculosis. Methods Fifty-nine patients with thoracic spinal tuberculosis were treated with transpedicular autogenous iliac bone fixation (autologous group), transpedicular approach with titanium mesh and allograft internal fixation in 26 cases (allograft group). The operation time, intraoperative bleeding volume, postoperative drainage volume, hospitalization time were compared between the two groups. The spinal Cobb angle was compared between the two groups before, immediately after operation and 9 months after operation. The fusion rate and fusion time of spinal graft were compared between the two groups at 3 and 9 months postoperatively. Results the operative time and the amount of intraoperative bleeding in the autologous group were higher than those in the allogeneic group (P 0.05, P < 0.05). Immediately after operation and 9 months after operation, the Cobb angle of spinal column in both groups was lower than that before operation (P < 0.05), but there was no significant difference between the two groups. There was no significant difference in the rate of bone graft fusion between the two groups at 6 and 9 months after operation, and the time of bone graft fusion in the autogenous group was shorter than that in the allogeneic group (P 0.05). Conclusion Transpedicular approach of autogenous iliac bone, titanium mesh and allogeneic bone fixation is effective in treating thoracic spinal tuberculosis, but the former is more beneficial to postoperative bone fusion than the latter.
【作者单位】：南阳医专第一附属医院;新乡医学院第一附属医院;
【基金】：河南省医学科技攻关计划项目(豫卫科201304029)
【分类号】：R687.3

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