摘要
目的分析我科10年间采用前入路手术治疗胸、腰椎结核疗效及所发生并发症的原因,探讨其相应对策。方法自1996年01月～2005年12月,采用前入路手术治疗胸腰椎结核患者120例,其中初诊115例,外院术后复发5例。结果初诊115例患者,5例复发;4例术中胸膜破裂,1例髂外静脉撕裂;3例胸12神经根后支损伤;1例下肢静脉栓塞,2例麻痹性肠梗阻,1例假性尿崩症;外院5例术后复发患者中,1例因急性肝功能衰竭而死亡;1例因内固定松动而接受第三次手术,1例为广泛耐药,而再次复发。结论规范化疗是防止结核病灶复发的关键,根据细菌培养和药敏结果调整化疗方案是预防结核耐药的最有效方法。
Objective To assess the effect of the anterior surgical approach for thoracolumbar spine tuberculosis and analyzed the causes of the surgical complications and the countermeasures. Methods From Jan 1996 to Dec 2005, 120 patients with thoracolumbar spine tuberculosis underwent operations through the anterior approach either following the primary diagnosis （115 cases） or for recurrence （5 cases）. Results Intraoperative pleural rupture occurred in 4 cases, and rupture of the external iliac vein occurred 1 case. Three patients had damages of the T12 dorsal ramus. One patient developed venous embolism of the lower extremity after the operation, two had paralytic ileus and 1 had false diabetes insipidus. Of the 5 recurrent patients, 1 died due to alcoholic cirrhosis and acute liver failure, 1 received a third operation for loosened internal fixation, and 1 had recurrence due to extensive drug resistance （XDR）. Conclusions Standardized antituberculous therapy is fundamental for preventing the recurrence of tuberculosis, and individualized antitubereulous therapy adjustment according to the results of bacterial culture and drug sensitivity tests can be the most effective means for preventing drug resistance and reducing tuberculosis recurrence.
出处
《南方医科大学学报》
CAS
CSCD
北大核心
2009年第6期1229-1231,1237,共4页
Journal of Southern Medical University
关键词
胸腰椎结核
前入路手术
疗效与并发症
thoracolumbar tuberculosis
anterior operation
effect and complications
