椎间孔镜下病灶清除治疗胸椎结核的效果观察

发布时间：2018-10-21 13:41

【摘要】：目的探讨椎间孔镜直视下清除结核病灶对胸椎结核的治疗效果。方法选取胸椎结核患者90例,随机分为对照组和观察组各45例。对照组采用开放式手术切除结核病灶,观察组给予椎间孔镜下清除结核病灶。统计两组手术时间、术中出血量;检测手术前后血清谷胱甘肽过氧化物酶(GSH-PX)、超氧化物歧化酶(SOD)、丙二醛(MDA)、晚期蛋白氧化产物(AOPP);检测手术前及手术后3个月红细胞沉降率(ESR),计算Cobb角,并进行Frankel脊髓损伤分级;统计术后3个月内并发症发生情况。结果观察组手术时间及术中出血量均少于对照组(P均0.05)。与同组术前比较,两组术后血清MDA、AOPP水平均升高,GSH-PX、SOD水平均降低,且对照组变化更明显(P均0.05)。与同组术前比较,术后3个月ESR和Cobb角均下降,Frankel分级C级例数均减少、E级例数均增加(P均0.05);上述指标组间比较差异均无统计学意义(P均0.05)。两组术后3个月内均未出现切口感染、脑脊液漏、神经损伤等并发症。结论椎间孔镜下摘除结核病灶可改善胸椎结核患者神经功能和脊椎侧弯,效果与传统开放手术相当,且手术创伤更小。
[Abstract]:Objective to investigate the effect of intervertebral foramen-guided debridement of tuberculosis on thoracic vertebral tuberculosis. Methods 90 patients with thoracic vertebral tuberculosis were randomly divided into control group (n = 45) and observation group (n = 45). The patients in the control group were treated with open surgical excision, and the patients in the observation group were treated with intervertebral foramen to clear the tuberculosis foci. The time of operation and the amount of blood loss in the two groups were calculated. Before and after operation, serum glutathione peroxidase (GSH-PX) and superoxide dismutase (SOD),) malondialdehyde (MDA),) late protein oxidation product (AOPP);) were detected. The erythrocyte sedimentation rate (ESR),) was calculated before operation and 3 months after operation. Frankel spinal cord injury was graded. The incidence of complications within 3 months after operation was analyzed. Results the time of operation and the amount of intraoperative bleeding in the observation group were less than those in the control group (P 0.05). Compared with the same group, the serum MDA,AOPP level was increased and the GSH-PX,SOD level was decreased in the two groups after operation, and the change was more obvious in the control group (P < 0. 05). Compared with the same group, the ESR and Cobb angle decreased 3 months after operation, the number of Frankel grade C cases decreased, and the number of E grade cases increased (P0. 05), but there was no significant difference between the two groups (all P 0. 05). No incision infection, cerebrospinal fluid leakage and nerve injury were found in the two groups within 3 months after operation. Conclusion removal of tuberculosis under intervertebral foramen endoscopy can improve the neurological function and scoliosis in patients with thoracic spinal tuberculosis, and the effect is comparable to that of traditional open surgery, and the surgical trauma is less.
【作者单位】：济宁市第一人民医院;
【基金】：济宁市科技卫生类科研项目(济科字[2016]56号-1)
【分类号】：R687.3

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