单纯后路与一期前后路手术治疗胸腰椎结核.pdf

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1、复旦学报!医学版"!#(!"#$%&%'()*+#,-'!"#$)$%.#%"!#"单纯后路与一期前后路手术治疗胸腰椎结核李!娟!董!健"!李熙雷!周晓岗!马易群!李!超!复旦大学附属中山医院骨科!上海!!"""$!"#摘要$!目的!探讨单纯后路手术与一期前后路手术治疗胸腰椎结核是否有同等疗效&方法!收集了!""$年+月至!""'年#"月我院骨科采用椎弓根螺钉固定联合病灶清除植骨融合治疗的胸腰椎结核患者+'例资料#其中单纯后路手术组$"例#一期前后路手术组!'例#均采用标准疗程三联或四联抗结核方案&比较两组患者围手

2、术期指标#随访临床疗效*实验室及影像学资料#随访时间为%$##"'个月&结果!两组患者在住院时间*手术时间*出血量*输血量*引流天数及引流量等方面的差异有明显统计学意义&所有患者的临床症状均得到有效改善&单纯后路组#例术后$年出现肋骨结核及窦道##例术后%年出现其他部位结核#手术部位均未见复发&后凸/0KK角矫正均较满意&结论!两种术式治疗短节段胸腰椎结核疗效相当#单纯后路手术创伤较小#疗效满意#适用于不能耐受前路手术及双侧腰大肌脓肿的患者&#关键词$!胸腰椎结核'!腰大肌脓肿'!病灶清除'!后路内固定#中图分类号

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