影响脊柱结核术后超短程化疗方案的因素分析

发布时间：2018-07-21 20:18

【摘要】：目的探讨影响脊柱结核术后施行超短程化疗方案的因素。方法回顾性分析2004年1月-2013年12月在宁夏医科大学总医院脊柱骨科行手术治疗的211例脊柱结核患者。其中术后施行超短程化疗方案的患者120例,男59例、女61例,年龄37.91±16.71岁;非超短程化疗患者91例,男47例、女44例,年龄43.67±16.56岁。收集两组患者术前、术中的临床资料,包括初治或复治、年龄、术前是否合并其他疾病、是否合并其他部位活动性结核、是否贫血、病变累及节段、是否合并脓肿、手术分期、植骨材料、病灶彻底清除情况、植骨方式、耐药情况等12个方面。应用单因素Logistic回归分析,筛选出变量,再将其中有统计学意义的变量进行多因素Logistic回归分析,推测可能影响脊柱结核术后施行超短程化疗方案的因素。结果超短程化疗组120例随访时间38~154个月,平均90.11±30.81个月,化疗疗程3~6个月,平均4.65±0.98个月。非超短程化疗组91例随访时间45~153个月,平均89.73±28.08个月,化疗疗程6.5~34个月,平均11.32±5.30个月。单因素和多因素Logistic回归分析结果示:病灶彻底清除、植骨方式、累及节段等3个因素与超短程化疗方案有显著相关性(P0.05)。结论病灶彻底清除、支撑植骨是施行超短程化疗方案的有利因素;病变累及多节段是施行超短程化疗方案的不利因素。
[Abstract]:Objective to investigate the factors influencing the treatment of ultrashort chemotherapy for spinal tuberculosis. Methods from January 2004 to December 2013, 211 patients with spinal tuberculosis underwent surgical treatment in the Department of Spinal Orthopedics, Ningxia Medical University General Hospital. 120 patients (59 males and 61 females, aged 37.91 卤16.71 years) underwent ultrashort chemotherapy, and 91 patients (47 males and 44 females, aged 43.67 卤16.56 years) received ultrashort chemotherapy. The clinical data of the two groups were collected before and after operation, including initial treatment or relapse, age, whether other diseases were involved, whether other active tuberculosis was involved, whether anemia, involvement of lesions, abscess, and operative stages. Bone graft materials, complete clearance of lesions, bone grafting, drug resistance and other 12 aspects. Single factor logistic regression analysis was used to screen out the variables and then multivariate logistic regression analysis was carried out to speculate the factors that might influence the treatment of ultrashort chemotherapy after spinal tuberculosis operation. Results 120 cases of ultrashort chemotherapy group were followed up for 38 ~ 154 months (mean 90.11 卤30.81 months), the course of chemotherapy was 3 ~ 6 months (mean 4.65 卤0.98 months). The follow-up time was 45-153 months (mean 89.73 卤28.08 months) and the course of chemotherapy was 6.5 ~ 34 months (mean 11.32 卤5.30 months) in the non-ultrashort chemotherapy group. The results of univariate and multivariate logistic regression analysis showed that there were significant correlations among the three factors: complete debridement, bone grafting, and involvement level with the treatment of ultrashort chemotherapy (P0.05). Conclusion radical clearance and bone grafting are favorable factors for ultrashort chemotherapy, and multilevel involvement is the unfavorable factor for ultrashort chemotherapy.
【学位授予单位】：宁夏医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R687.3

【参考文献】