Richter R, Iljinski A, Krause F J, Schulz H J
Z Orthop Ihre Grenzgeb. 1986 Nov-Dec;124(6):692-700. doi: 10.1055/s-2008-1045024.
Between 1955 and 1980 a total of 67 patients (42 female, 25 male) with advanced tuberculosis of the pelvic girdle underwent surgery at the authors' clinic. In 43 patients the sacroiliac joint was affected (in 2 cases bilaterally), in 11 the ischium, in 9 the pubic bone, and in 2 each the ilium and the sacrum. The average of the patients (who included 4 migrant workers) was 44. The youngest patient was 8, the oldest 67 years old. The average interval between the onset of complaints and diagnosis was 4.6 years (minimum 1 month, maximum 20 years). Thirty-eight of the patients had already had treatment for an organic or osteoarticular tuberculosis. Although 24 (35.8%) of the patients were simultaneously suffering from a florid, specific infection localized elsewhere, and abscesses, fistulas, or a combination of these were identified in 40 patients (59.7%), only 17 (25.4%) were in slightly impaired general condition, and in over one-half of the patients, the hourly blood sedimentation rate was normal or only slightly elevated (up to 20 mm n.W.). In 9 cases (13.4%) the only pointers to tuberculosis were the patient's history, clinical and radiological findings, and the subsequent evolution of the disease. In these cases the diagnosis could not be confirmed either by histologic or by bacteriologic study of focal tissue. In 67 patients, 66 osseous foci were removed and in 2 cases merely an abscess (after an average of 2-3 weeks' tuberculostatic therapy), the bone cavities were filled with a mixture of heterogeneous or autogenous spongiosa and tuberculostatics or merely with chemotherapeutic drugs, and primary closure of the wound was performed.(ABSTRACT TRUNCATED AT 250 WORDS)
1955年至1980年间,共有67例骨盆带晚期结核病患者(42例女性,25例男性)在作者所在诊所接受了手术。43例患者骶髂关节受累(2例双侧受累),11例坐骨受累,9例耻骨受累,2例髂骨和骶骨分别受累。患者(其中包括4名农民工)的平均年龄为44岁。最年轻的患者8岁,最年长的67岁。从出现症状到确诊的平均间隔时间为4.6年(最短1个月,最长20年)。38例患者已接受过器质性或骨关节结核的治疗。尽管24例(35.8%)患者同时患有其他部位的活动性特异性感染,40例患者(59.7%)发现有脓肿、瘘管或两者兼有,但只有17例(25.4%)患者一般状况轻度受损,超过一半的患者每小时血沉正常或仅略有升高(最高20mm/h)。9例(13.4%)患者结核病的唯一线索是患者病史、临床和放射学表现以及疾病的后续演变。在这些病例中,通过局部组织的组织学或细菌学研究均无法确诊。67例患者中,切除了66个骨病灶,2例仅切除了脓肿(经过平均2至3周的抗结核治疗后),骨腔用异体或自体松质骨与抗结核药的混合物填充,或仅用化疗药物填充,伤口一期缝合。(摘要截取自250字)