单纯后路手术与前后路联合手术治疗脊柱结核的临床疗效对比研究

发布时间：2018-12-11 18:57

【摘要】：目的:通过比较单纯后路手术与前后路联合手术治疗脊柱结核患者的手术资料和术后随访资料,分析两种手术的临床疗效,评价单纯后路手术的有效性及安全性,为单纯后路手术治疗脊柱结核提供循证医学证据。方法:回顾性分析2003年1月至2013年6月在南昌大学第一附属医院接受手术治疗的脊柱结核患者。总共纳入165例患者,单纯后路手术组76例,前后路联合手术组89例,其中男73例,女92例,单纯后路手术组男37例,女39例,前后路联合手术组男36例,女53例。比较两组患者术前、术后及末次随访的VAS评分、JOA评分、术后住院时间、住院费用(除器械费用外)、手术时间、术中出血量、术后植骨融合时间、并发症发生例数,以及局部后凸Cobb角变化,随访方式为出院后第3、6、9、24个自然月到我院门诊或住院部进行常规随访。结果:单纯后路手术组在手术时间、术中出血量、术后住院时间、术后JOA评分、以及后凸Cobb角的矫正率上均优于前后路联合手术组,而植骨融合时间、术后并发症例数、末次随访JOA评分、出院时和末次随访VAS评分两者相比无统计学差别。结论:单纯后路手术较前后路联合手术疗效更确切、安全,是治疗脊柱结核的合理选择,具有重要的临床应用价值。
[Abstract]:Objective: to evaluate the efficacy and safety of posterior and posterior approaches in the treatment of spinal tuberculosis by comparing the surgical data and follow-up data of patients with spinal tuberculosis. To provide evidence-based medical evidence for the treatment of spinal tuberculosis by posterior approach alone. Methods: from January 2003 to June 2013, patients with spinal tuberculosis undergoing surgical treatment in the first affiliated Hospital of Nanchang University were analyzed retrospectively. A total of 165 patients were included in the study, 76 cases in the posterior approach group and 89 cases in the combined anterior and posterior approach group, including 73 males and 92 females, 37 males, 39 females, 36 males and 53 females in the combined anterior and posterior approach group. The VAS score, JOA score, postoperative hospitalization time, hospitalization cost (other than equipment cost), operation time, intraoperative bleeding volume, postoperative bone graft fusion time, and the number of complications were compared between the two groups. And the change of Cobb angle of local kyphosis was followed up by routine follow up in outpatient department or inpatient department of our hospital in 24 months after discharge. Results: the postoperative time, blood loss, postoperative hospitalization time, postoperative JOA score and correction rate of kyphosis Cobb angle in the simple posterior approach group were better than those in the anterior and posterior approach combined operation group, but the time of bone graft fusion and postoperative complications were better than those in the anterior and posterior approach combined operation group. There was no significant difference between the JOA score at the last follow-up and the VAS score at the discharge and the last follow-up. Conclusion: simple posterior approach is more effective and safe than combined anterior and posterior surgery. It is a reasonable choice for the treatment of spinal tuberculosis and has important clinical application value.
【学位授予单位】：南昌大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R687.3

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