资源描述：
《孤立性脊柱椎弓结核的临床特点及诊断治疗》由会员上传分享，免费在线阅读，更多相关内容在工程资料-天天文库。
1、屮华结核和呼吸感染作者：林羽吴启秋单位：101149北京,关键词：结核,【摘要】目的孤立性脊柱椎弓结核的临床特点及诊断治疗1998年第10期第21卷论著徐双铮管波清北京市结核病胸部肿瘤研究所件科骨关节；椎弓；诊断；外科，手术探讨脊柱椎弓结核的临床特点及诊断与治疗。方法对1956〜1996年收治的3825例脊椎结核中的17例椎弓结核的临床表现及治疗进行冋顾性分析。结果17例椎弓结核屮除1例为2岁儿童外，余均为青壮年，早期症状不典型，仅有局部固定性疼痛和压痛，以后有脓肿痿管和神经系统症状出现。均经病史、体征、影像学检查及细菌学检杳综合诊断，其
2、中仅1例误诊。17例中1例行抗结核药物化疗，16例在抗结核勿物化疗下行椎弓病灶清除术，其中4例伴有神经系统症状者同期作了椎板切除减压治疗。结杲全部治愈,经随访无1例复发。结论椎弓结核早期症状较隐匿不易诊断，但限局性疼痛及X线、CT、磁共振(MRI)等检查对该症的早期诊断极有帮助，脓肿穿刺、抗酸染色涂片检查常能明确诊断。手术是椎弓结核治疗的重要手段。Clinicalfeatures,diagnosisandtreatmentofsolitaryvertebralarchtuberculosisLinYu,WuQiqiu,XuShuangzh
3、eng,etal.BeijingTuberculosisandThoracicTumourInstitute,Beijing101149[Abstract】ObjectiveToexploreclinicalfeaturesofvertebralarchtuberculosis,andtodiscussthediagnosisandtreatmentofthisillness.MethodSeventeenof3825casesofspinaltuberculosiswhowerehospitalizedandtreatedfrom195
4、6to1996werereviewed,andtheirclinicalfeatures,diagnosisandtreatmentwereanalysedandreported.ResultSixteencasesofvertebralarchtuberculosiswereinadolescenceandprimeoflife,andanotheronewasa2-year-oldchild・Theirsymptomsinearlystageswereuntypical,includinglocalfixedpainandtender
5、ness,andlater,abscess,fistulaandsymptomsofnervesystemappeared・Allthecaseswerediagnosedthroughsummarizingoftheirhistory,signs,imagingexaminationandbacteriologytests,andonlyonecasewasmisdiagnosed・Inoneof17cases,antituberculosischemotherapywasconductedaloneandnon-operationwa
6、sperformed.Intheother16cases,focaldebridementofvertebralarchwasperfonnedonthebasisofantituberculouschemotherapy,andin4casesofthemwithsymptomsofnervesystem,laminectomyandspinaldecompressionwasperformedhomochronously.Allthecaseswerehealedandnorelapseoccuredduringfollow-up.C
7、onclusionItisdifficulttodiagnosevertebralarchtuberculosisinearlystagesduetoitsoccultsymptoms,butthesymptomofconfinedpainandmanifestationinX-ray,CTandMRIaremuchusefulforearlydiagnosis.Abscesspunctureandacid-faststainingsmearmicroscopycanusuallybeusedtoconfirmdiagnosis.Ands
8、urgicalinterventionisanimportantmeasureforitstreatment・[Keywords]Tuberculosis,osteoailicularVert
