[1]周春光,刘立岷,宋跃明,等.后路手术治疗老年中下胸椎结核的疗效分析[J].中华老年骨科与康复电子杂志,2016,(04):193-197.[doi:10.3877/cma.j.issn.2096-0263.2016.04.001]
　Zhou Chunguang,Liu Limin,Song Yueming,et al.Posterior surgery for elderly patients with middle or lower thoracic tuberculosis[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2016,(04):193-197.[doi:10.3877/cma.j.issn.2096-0263.2016.04.001]
点击复制

后路手术治疗老年中下胸椎结核的疗效分析()
分享到：

中华老年骨科与康复电子杂志[ISSN:1674-3911/CN:11-9292/R]

卷:
期数:
2016年04期
页码:
193-197
栏目:
脊柱专题
出版日期:
2016-11-05

文章信息/Info

Title:
Posterior surgery for elderly patients with middle or lower thoracic tuberculosis
作者:
周春光; 刘立岷; 宋跃明; 李涛; 龚全; 曾建成; 杨曦; 汪雷
610041 成都，四川大学华西医院骨科
Author(s):
Zhou Chunguang;  Liu Limin;  Song Yueming;  Li Tao;  Gong Quan;  Zeng Jiancheng;  Yang Xi;  Wang Lei
Department of Orthopaedics, West China Hospital, Sichuan University, Chengdu 610041, China
关键词:
老年人;  胸椎;  结核;  病灶清除术;  植骨
Keywords:
Aged;  Thoracic vertebra;  Tuberculosis;  Debridement;  Bone transplantation
DOI:
10.3877/cma.j.issn.2096-0263.2016.04.001
文献标志码:
A
摘要:
目的 探讨后路手术治疗老年人中下胸椎结核的疗效。方法 回顾性分析 2011年 5月至 2014年 6月四川大学华西医院收治的 24例老年中下胸椎结核患者，男 10例，女 14例；年龄 62～83岁，平均（75±6）岁。均采用一期经后路病灶清除椎体间植骨融合内固定术治疗。记录患者的手术时间、术中出血量、术前术后神经功能分级及后凸角度。结果 所有患者均获得随访，随访时间24～48个月，平均（30±9）个月。手术时间150～220 min，平均（175±26）min，术中失血量300～1500 ml，平均（630±276）ml。所有患者术后均未出现呼吸困难，10 例患者发现少量胸腔积液，但均不需要放置胸腔闭式引流。无窦道形成、感染性脑脊髓膜炎、结核复发等情况。植骨融合时间为 3～12个月，平均（6.0±2.2）个月。所有患者内固定位置良好，无松动、断裂等并发症发生。末次随访时18例脊髓神经功能损害患者的神经功能改善 1～2级。后凸角度由术前（19.4±7.1）°改善至术后即刻（9.0±4.9）°，差异具有统计学意义（t=10.475， P＜0.05），末次随访矫正角度平均丢失（1.6±0.5）°。结论 对于老年中下胸椎结核患者，采用一期经后路病灶清除椎体间植骨融合内固定的手术方式可以达到较满意的治疗效果。
Abstract:
Objectives To evaluate the results of posterior surgery for elderly patients with middle or lower thoracic tuberculosis. Methods Twenty- four elderly patients with middle or lower thoracic tuberculosis were admitted in west China Hospital from May 2011 to June 2014. There were 10 males and 14 females, with an average age of (75 ± 6) years (range, 62 to 83 years). All cases underwent one- stage posterior debridement together interbody bone graft and internal fixation. The operation time, blood loss, preoperative and postoperative neurological function and kyphosis angle were reviewed. Results All cases were well followed up for 24 to 48 months, with an average of 30±9 months. The operation time ranged from 150 min to 220 min, with an average of (175±26) min. The blood loss were 300 to 1500 ml, with an average of (630±276) ml. No dyspnea happened in all patients after operation. A small amount of pleural effusion was found in 10 patients but did not need thoracic closed drainage. No sinus tract, cerebrospinal meningitis or recurrence of tuberculosis did not occur. All patients achieved solid fusion within 3 to 12 months after operation, with an average of (6.0±2.2) months. No instrumentation failure was found. At the final follow-up, neurological function score of 18 patients with neurological compromise increased 1 to 2 grades. At the final follow- up, the kyphosis angle improved to (9.0 ± 4.9)° from preoperative (19.4 ± 7.1)° with statistical significance (t=10.475，P<0.05), and the average loss of corrective angle was 1.6 ± 0.5° . Conclusion One- stage posterior debridement together interbody bone graft and internal fixation can achieve satisfactory results in elderly patients with middle or lower thoracic tuberculosis.

相似文献/References:

[1]赵晨,商培洋,车凌宾,等.锁定钢板治疗老年肱骨近端骨折合并肩袖撕裂的疗效分析[J].中华老年骨科与康复电子杂志,2015,(01):22.
[2]吴斗,郝海虎,朱剑,等.老年髋部骨折术后谵妄的危险因素分析[J].中华老年骨科与康复电子杂志,2015,(01):34.
[3]高文双,曹建业,吴卫卫,等.墙壁拉力器训练对老年下腰背痛的疗效研究[J].中华老年骨科与康复电子杂志,2015,(01):39.
[4]姬晨妮,陈伟,朱燕宾,等.京津唐地区1 583例老年股骨转子间骨折流行病学特征分析[J].中华老年骨科与康复电子杂志,2015,(01):45.
[5]李石伦,鞠林林,陈伟,等.老年脊柱骨折的流行病学特征分析[J].中华老年骨科与康复电子杂志,2015,(01):50.
[6]杨延江　董天华　杜晨光　杨宗酉　陈伟　吕红芝　刘磊　孙家元　王海立　殷兵　 刘勃 刘松　张英泽.2008 年至2012 年河北医科大学第三医院 老年踝关节损伤的流行病学研究[J].中华老年骨科与康复电子杂志,2015,(02):35.[doi:10.3877/cma.j.issn.2096-0263.2015.02 .007]
　Yang Yanjiang,Dong Tianhua,Du Chenguang,et al.Epidemiological analysis of elderly ankle injury in the Third Hospital of Hebei Medical University from 2008 through 2012[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2015,(04):35.[doi:10.3877/cma.j.issn.2096-0263.2015.02 .007]
[7]吕厚辰,唐佩福.老年髋部骨折患者死亡风险评价[J].中华老年骨科与康复电子杂志,2016,(02):109.[doi:10.3877/cma.j.issn.2096-0263.2016.02.009]
　Lyu Houchen,Tang Peifu..Advancement of mortality prediction of aged hip fracture patients[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2016,(04):109.[doi:10.3877/cma.j.issn.2096-0263.2016.02.009]
[8]高延征,张广泉,邢帅,等.经皮椎体成形术与经皮椎体后凸成形术治疗老年 Kümmell 病的对比研究[J].中华老年骨科与康复电子杂志,2016,(03):136.[doi:10.3877/cma.j.issn.2096-0263.2016.03.002]
　Gao Yanzheng,Zhang Guangquan,Xing Shuai,et al.Comparative analysis of percutaneous vertebroplasty and percutaneous kyphoplastyon in the treatment of the elderly with Kümmell disease[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2016,(04):136.[doi:10.3877/cma.j.issn.2096-0263.2016.03.002]
[9]于沂阳,刘勃,陈伟,等.2008—2012 年河北医科大学第三医院老年骨折流行病学特征分析[J].中华老年骨科与康复电子杂志,2016,(03):172.[doi:10.3877/cma.j.issn.2096-0263.2016.03.009]
　Yu Yiyang,Liu Bo,Chen Wei,et al.Epidemiological analysis of geratic fractures in the Third Affiliated Hospital to Hebei Medical University from 2008 to 2012[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2016,(04):172.[doi:10.3877/cma.j.issn.2096-0263.2016.03.009]
[10]李玉龙,翁习生,董玉雷.老年全膝关节置换术围手术期并发症影响因素的研究进展[J].中华老年骨科与康复电子杂志,2016,(03):177.[doi:10.3877/cma.j.issn.2096-0263.2016.03.010]
　Li Yulong,Weng Xisheng,Dong Yulei.Research progress of influence factors concerning perioperative complications of total knee arthroplasty in aged patients[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2016,(04):177.[doi:10.3877/cma.j.issn.2096-0263.2016.03.010]

备注/Memo

备注/Memo:
基金项目：国家自然科学基金（81401760）
更新日期/Last Update: 2017-04-01