摘要
目的探究侧前方入路治疗后路胸腰椎结核术后复发和未愈的疗效。方法 60例后路胸腰椎结核术后复发、未愈患者。通过动态随机化分组的方式,在保证公平、随机的基础上,将患者分为观察组和对照组,每组30例。对照组采取后路治疗,观察组采取侧前方入路治疗。比较两组患者治疗效果、不良反应发生情况、手术情况、视觉模拟评分法(VAS)评分及日本骨科协会评估量表(JOA)评分。结果观察组治疗总有效率96.7%高于对照组的73.3%,差异具有统计学意义(P<0.05)。观察组不良反应发生率6.7%低于对照组的30.0%,差异具有统计学意义(P<0.05)。观察组患者手术时间(62.1±1.7)min短于对照组的(81.9±1.8)min,术中出血量(108.7±1.2)ml少于对照组的(164.4±1.5)ml,差异均具有统计学意义(P<0.05)。治疗后,两组患者VAS评分和JOA评分均有所改善,且观察组患者VAS评分(2.7±0.6)分和JOA评分(15.8±1.2)分均优于对照组的(4.1±0.5)、(11.6±1.5)分,差异均具有统计学意义(P<0.05)。结论对后路胸腰椎结核术后复发和未愈的患者采取侧前方入路治疗的效果较好,及时帮助患者清除病灶,减轻患者疼痛的同时,改善患者的胸腰椎功能,此方法临床应用的安全性较高,值得推广。
Objective To investigate the efficacy of lateral anterior approach in the treatment of recurrence and unhealed posterior thoracolumbar tuberculosis after surgery. Methods A total of 60 patients with recurrence and unhealed posterior thoracolumbar tuberculosis after surgery were divided into observation group and control group according to dynamic randomization grouping method, with 30 cases in each group. The control group was treated with posterior approach, and the observation group was treated with lateral anterior approach. The therapeutic effect, occurrence of adverse reactions, surgical situation, visual analogue scale(VAS) score and Japanese Orthopaedic Association(JOA) score were compared between the two groups. Results The total effective rate 96.7% of the observation group was higher than 73.3% of the control group, and the difference was statistically significant(P<0.05). The incidence of adverse reactions 6.7% of the observation group was lower than 30.0% of the control group, and the difference was statistically significant(P<0.05). The operation time(62.1±1.7) min of the observation group was shorter than(81.9±1.8) min of the control group, and intraoperative blood loss(108.7± 1.2) ml was less than(164.4±1.5) ml of the control group, and the difference was statistically significant(P<0.05). After treatment, the VAS score and JOA score of the two groups were improved, and the VAS score(2.7± 0.6) points and JOA score(15.8±1.2) points of the observation group were all better than(4.1±0.5) and(11.6± 1.5) points of the control group, and the difference was statistically significant(P<0.05). Conclusion Lateral anterior approach shows good effect for patients with recurrence and unhealed thoracolumbar tuberculosis after surgery. It helps patients clear the lesions in time, relieve the pain of the patients, and improve the thoracolumbar function of the patients. This method is safe in clinical application, and is worthy of promotion.
作者
施宗祥
朱德智
SHI Zong-xiang;ZHU De-zhi(Department of Orthopedics,Fourth Hospital of Inner Mongolia Autonomous Region,Hohhot 010080,China)
出处
《中国实用医药》
2021年第7期34-37,共4页
China Practical Medicine
关键词
侧前方入路
后路胸腰椎结核
复发
疗效
Lateral anterior approach
Posterior thoracolumbar tuberculosis
Recurrence
Efficacy
