资源描述：
《脊柱结核的诊断和治疗(附42例报告)》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、脊柱结核的诊断和治疗(附42例报告)【摘要】目的：探讨脊柱结核的诊断和治疗方法。方法：回顾2(X)1年1月〜2(X)6年6月我科收治42例脊柱结核患者的临床表现、病史、症状和体征、实验室检查、相应的组织病理学检杏结果、影像学特征、治疗方式、治疗时间、随访时间和疗效。结果：30%的患者有活动性肺结核接触史，最常见症状为腰背痛(92.5%),脊柱棘突叩床痛(55.0%)。核磁是诊断脊柱结核的有效方式，腰椎受累为34例(81.0%)，标木结核杆菌培养结果呈阳性的占52.9%,抗酸杆菌染色涂片呈阳性的占47.0%。抗结核耐药占44.4%,单纯药物治疗占15%,最终手术T预患
2、者占85%,平均治疗时间(12±12)个月,平均随访时间为(10.5±6.6)个月。症状明显改善，结核治愈无复发占77.5%。结论：成人脊柱结核应早诊断、早治疗，延误诊断可能导致严重后果并影响预后。除了遵循早期、联合、适量、规律、全程的治疗原则外，细菌培养+抗结核药敏试验对治愈脊柱结核也很重耍。【关键词】脊柱结核；诊断；治疗Diagnosisandtreatmentofspinaltuberculosis(reportsof42cases)CHUGe,WANGZhenbin,ZHAOJiang,etalDepartmentofSpinalSurgery,Affili
3、atedHospitalofTraditionalChineseMedicine,XinjiangMedicalUniversity,Urumqi830011,ChinaAbstract:Objective:Toexplorethemethodsofdiagnosisandtreatmentforspinaltuberculosis.Methods:FromJanuary2001toJune2006,42casesofspinaltuberculosiswereanalyzedretrospectively,includingclinicalmanifestatio
4、n,history,singsandsymptoms,laboratoryexamination,correspondinghistopathologyexamination,imagingfeatures,treatingmethods,timeoftherapy,followuptimeandcurativeeffect.Results:Amongthesepatients,30%contactedpatientswithactivetuberculosis,themostsymptomwerelumbodorsalpain(92.5%),spinousproc
5、esstenderness(55%).MRIwasveryusefultodiagnosespinaltuberculosis,lumbaristhemostcommonsitetobeinvolvedin(82.5%),30cases(75%)hadlaterovertebralabscessus,4cases(10%)accompaniedwiththetuberculosisofsacroiliacjoint,histopathologyexaminationshowedtuberculousgranulomain76.5%,tuberclebacillusc
6、ultureshowedpositiveaccountedto52.9%,stainsmearofacidfastbacillishowedpositivein47%・Antituberculosisdrugresistantwas44.4%,simpledrugtreatmentwas15%,ultimateoperationwas85%,averagetimeoftherapywas(12±12)months,averagefollowuptimewas(10-5+6.6)months.Symptomswereimprovedobviouslyandcuredw
7、ithoutrecurrencein77.5%・Conclusions:Foradultsspinaltuberculosisshouldbeearlydiagnosedandtreated,delaydiagnosiswouldberesultinseriousconsequenceandinfluenceprognosis・Weshouldnotonlyabidebythetherapeuticprinciplesasfollows:earlierperiod,combination,regularpattern,fullrange,butalsomakeb
