摘要
目的分析影响胸腰椎结核患者术后复发的危险因素。方法选取2010-01-2016-01实施一期后路病灶清除、植骨融合内固定术治疗的胸腰椎结核患者230例,术后随访1年,其中复发30例,未复发200例,对比复发与未复发患者临床资料,分析复发特点、复发原因、复发影响因素及预防措施。结果复发患者胸壁或腰椎肿块伴轻微胸痛,形成脓肿有波动感,部分局部伤口破溃迁延不愈,病灶清除不彻底、耐药性结核菌株出现、非活性异物过多放置、内固定松动失效、不正规化疗、长期营养不良是复发的主要原因。多因素Logistic回归分析结果显示,术前抗结核治疗时间短、未达术后制动时间、手术清除病灶不彻底、术后未规范治疗是导致术后复发的独立危险因素(P<0.05)。结论胸腰椎结核患者术前抗结核治疗时间短、未达术后制动时间、手术清除病灶不彻底、术后未规范治疗是导致术后复发的独立危险因素,临床医师应给予足够重视。
Objective To analyze the risk factors of postoperative recurrence of thoracolumbartuberculosis patients. Methods From January 2010 to January 2016, 230 patients with thoracolumbartuberculosis treated with one-stage debridement, bone graft fusion and internal fixation in our hospitalwere selected in the study. After 1 year of follow-up, there were 30 cases of recurrence and 200 casesof non -recurrence. The clinical data of the patients with recurrence and non -recurrence werecompared, and the characteristics, the cause and the influencing factors of recurrence and thepreventive measures were analyzed. Results The main manifestations of the recurrence patients werechest wall or lumbar mass with mild chest pain, a sense of volatility in the formation of abscess,delayed healing of some local wound ulceration, not completely cleared lesions, the appearance ofresistant tuberculosis strains, too much placement of non-active foreign body, internal fixation failure,irregular chemotherapy, long-term malnutrition. Multivariate Logistic regression analysis showed thatthe short time of anti -tuberculosis treatment, the non -reaching postoperative braking time, theincomplete surgical clearance and the postoperative non-standardized treatment were the independentrisk factors for postoperative recurrence （P〈0.05）. Conclusions The short time of preoperative anti-tuberculosis treatment, non-reaching postoperative braking time, incomplete surgical removal of lesionsand the postoperative non -standard treatment in the thoracolumbar tuberculosis patients areindependent risk factors for postoperative recurrence, therefore clinicians should give enough attention.
作者
陈林全
代飞
CHEN Lin-quan;DAI Fei(Ren＇s Orthopaedis Hospital of Sichuan Province,Qionglai,Sichuan,611530;Department ofOrthopedics,Southwest Hospital,Chongqing,400038,China.)
出处
《颈腰痛杂志》
2018年第6期728-731,共4页
The Journal of Cervicodynia and Lumbodynia
关键词
胸腰椎结核
术后复发
危险因素
thoracolumbar tuberculosis
postoperative recurrence
risk factors
