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儿童骨关节结核

Osteoarticular tuberculosis in children.

作者信息

Singh S B, Saraf S K, Singh L I, Srivastava T P

机构信息

Department of Orthopedics, Banaras Hindu University, Varanasi.

出版信息

Indian Pediatr. 1992 Sep;29(9):1133-7.

PMID:1452310
Abstract

One hundred and four cases of osteoarticular tuberculosis were studied. There were 74 boys (71.2%) and 30 girls (28.8%). The mean age at the onset of symptoms was 7.3 years, ranging from 9 months to 18 years. Seventy four cases (71%) reported 3 months after onset of symptoms. The spine was the commonest site involved (43%) followed by hip (14.9%) and knee joints (10.3%). Evidence of active or inactive pulmonary tuberculosis was found in 16.2%. All cases were treated by three drug regimen of rifampicin, isoniazid and ethambutol; rifampicin was discontinued after 6 months, ethambutol after 12-14 months. In 12 cases (11.5%) isoniazid was continued for 18 months. Along with chemotherapy suitable braces, splints, tractions, exercises and other form of physical therapy produced satisfactory results. Seventy eight patients (75%) showed clinical and radiological improvement with one year of treatment. The follow up period ranged between 4 months to 24 months with an average of 17 months. Children because of capacity to grow, showed progressive deformity in knee in 3 cases (2.8%), hip in 98 cases (8.6%), shortening of limbs in 14 cases (13.4%) and kyphosis in 13 cases (12.5%).

摘要

对104例骨关节结核患者进行了研究。其中男孩74例(71.2%),女孩30例(28.8%)。症状出现时的平均年龄为7.3岁,范围从9个月至18岁。74例(71%)在症状出现后3个月就诊。脊柱是最常受累的部位(43%),其次是髋关节(14.9%)和膝关节(10.3%)。16.2%的患者有活动性或非活动性肺结核证据。所有病例均采用利福平、异烟肼和乙胺丁醇三联药物治疗方案;利福平在6个月后停用,乙胺丁醇在12 - 14个月后停用。12例(11.5%)患者异烟肼持续使用18个月。除化疗外,合适的支具、夹板、牵引、锻炼及其他形式的物理治疗均取得了满意效果。78例患者(75%)在治疗1年后临床和影像学表现有所改善。随访时间为4个月至24个月,平均为17个月。由于儿童具有生长能力,3例(2.8%)出现膝关节渐进性畸形,98例(8.6%)出现髋关节畸形,14例(13.4%)出现肢体缩短,13例(12.5%)出现脊柱后凸。

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