109例脊柱结核病灶清除术失败原因分析
[Analysis of reasons failed focal debridement in 109 patients with spinal tuberculosis].
作者信息
Zhang W, Wu Q, Lin Y
机构信息
Beijing Tuberculosis and Thoracic Tumour Institute, Beijing 101149.
出版信息
Zhonghua Jie He He Hu Xi Za Zhi. 1998 Mar;21(3):181-3.
OBJECTIVE
To explore reasons failed focal debridement in treating spinal tuberculosis patients and methods to cope with them.
METHOD
One hundred nine patients with spinal tuberculosis who failed initial focal debridement from 1987 to 1996 were reviewed.
RESULT
The reasons of operational failure were found to be the use of unreasonable regimens and existence of drug resistant strains; inappropriate operational indication, approach and treatment during operation; lesions involving several vertebrae, skipping destruction and complicating with other kinds of extrapulmonary tuberculosis.
CONCLUSION
The key to successful treatment of the disease is to choose appropriate operative indication and approach, discard spinal cord pressure and rebuild spinal stability on the basis of reasonable chemotherapy regimen.
目的
探讨脊柱结核病灶清除术失败的原因及应对方法。
方法
回顾性分析1987年至1996年109例初次病灶清除术失败的脊柱结核患者。
结果
手术失败的原因包括治疗方案不合理及存在耐药菌株；手术适应证、手术入路及术中处理不当；病变累及多个椎体、跳跃性破坏并合并其他肺外结核。
结论
成功治疗该病的关键在于选择合适的手术适应证和手术入路，解除脊髓压迫，并在合理化疗方案的基础上重建脊柱稳定性。
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