摘要
目的探讨早期骶髂关节结核的诊断方法及疗效。方法分析2005年2月至2011年6月在武警北京市总队第二医院就诊并接受治疗的20例早期骶髂关节结核患者,依据临床表现、影像学特征及穿刺活检病理检查明确诊断,按照Kim分型,其中Ⅱ型8例,Ⅲ型12例。行手术病灶刮除、取自体骨进行植骨术。观察其治疗效果,采用Majeed评分系统,从疼痛(30分)、工作(36分)、就座(10分)、性生活(4分)和站立(20分)方面分别评分,总分为100分,计算总分后进行临床分级,优(>85分)、良(70～84分)、中(55～69分)、差(<55分)四级。本组患者术前Majeed评分,其中优0例、良2例、中14例、差4例。结果20例患者全部获得随访,随访时间12～36个月,无复发、感染及骶髂关节分离脱位等并发症,所有患者均于术后3～6个月恢复正常训练及出勤。术前Majeed评分平均(61.75±6.54)分,术后末次随访平均(92.75±3.70)分,术后Majeed评分均较术前显著提高(t=3.481,P<0.001)。结论早期骶髂关节结核可依据临床表现、影像学特征及穿刺活检病理检查得以早期明确诊断,降低误诊率;进行系统规范的抗结核药物及手术治疗,预后及疗效满意。
Objective To discuss diagnosis methods and curative effect for the early sacroiliac joint tuberculosis. Methods Twenty patients with early sacroiliac joint tuberculosis from February 2005 to June 2011 in the Second Hospital of Peking Armed Police were enrolled. Diagnosis was primarily identified by clinical manifestations,imaging features and biopsy, with the kim type Ⅱ8 cases, type Ⅲ12 cases. Patients received intralesional curettage and autologous bone grafting.To observe the effect of the treatment, Majeed rating system was used, in which score was evaluated from five aspects including the pain （30 points）, work （36 points）, seating （10 points）, sex （4 points） and stand （20 points）.The total score is 100 points and clinical classification is evaluted by calculating the total points： optimal（〉85 points）, good（70-84 points）, medium（55-69 points）, poor（〈55 points）. For all the cases’ preoperative Majeed score, no patients reached optimal, 2 got good level, 14 cases got medium level, and 4 cases was poor. Results Twenty patients were followed up for 12 to 36 months. No patients developed recurrence, infection and dislocation of sacroiliac joint complications such as dislocation, all patients resumed normal training and attendance after 3-6 months. Preoperative Majeed scoring average was（61.75±6.54） points, the final follow-up average of （92.75±3.70） points with significantly difference（t=3.481,P〈0.001）. Conclusion Early sacroiliac joint tuberculosis can be diagnosed early by clinical manifestations, imaging features and biopsy. Patients can obtain satisfactory curative effect by receiving system standard antituberculosis drugs and operation treatment.
出处
《中国防痨杂志》
CAS
2013年第5期322-325,共4页
Chinese Journal of Antituberculosis
关键词
结核
骨关节
诊断
结核
骨关节
外科学
骶髂关节
抗结核药
预后
Tuberculosis, osteoarticular/diagnosis, Tuberculosis, osteoarticular/surgery, Sacroiliac joint, Antitubercular agents, Prognosis
