[1]赵涛,高腾飞,霍雪娥.脊柱结核患者330例临床疗效及预后研究[J].陕西医学杂志,2026,(4):512-516,528.[doi:DOI:10.3969/j.issn.1000-7377.2026.04.014]
　ZHAO Tao,GAO Tengfei,HUO Xuee.Study on clinical efficacy and prognosis of 330 patients with spinal tuberculosis[J].,2026,(4):512-516,528.[doi:DOI:10.3969/j.issn.1000-7377.2026.04.014]
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脊柱结核患者330例临床疗效及预后研究

《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
期数:
2026年4期
页码:
512-516,528
栏目:
临床研究
出版日期:
2026-04-05

文章信息/Info

Title:
Study on clinical efficacy and prognosis of 330 patients with spinal tuberculosis
作者:
赵涛; 高腾飞; 霍雪娥
（陕西省结核病防治院 陕西省第五人民医院结核外科，陕西 西安710010）
Author(s):
ZHAO Tao; GAO Tengfei; HUO Xue’e
（Shaanxi Province Tuberculosis Prevention and Treatment Institute The Fifth People’s Hospital of Shaanxi Province，Xi’an 710100，China）
关键词:
脊柱结核; 手术时机; 抗结核治疗; 病灶清除; 稳定性; 复发
Keywords:
Spinal tuberculosis; Timing of surgery; Antituberculosis treatment; Lesion clearance; Stability; Recurrence
分类号:
R 529.2
DOI:
DOI:10.3969/j.issn.1000-7377.2026.04.014
文献标志码:
A
摘要:
目的：探究脊柱结核患者诊治及预后情况，提高脊柱结核患者的疗效措施。方法：回顾性分析330例脊柱结核患者的临床及随访资料。结果：330例患者术前最短抗痨3周，最长抗痨7周，术后最短抗痨12个月，最长24个月；颈椎6例，胸椎结核病例75例，胸腰段结核99例，腰椎结核104例，腰骶椎结核46例；行前路手术固定者231例，后路固定者99例。术前术后随访12个月以上,脊柱内固定无松动、断裂、脱出等,植骨处均已骨性融合。术前脊髓神经功能按Franckel脊髓损伤分级，其中A级0例，B级6例，C级15例，D级24例，E级285例，术后均恢复到E级。结核椎体矢状面Cobb角的变化由术前(28.3±4.7)°降低为术后(11.32±2.65)°。治疗效果优 256 例（77.58%）、良 74 例（22.42%）。结论：术前及术后合理，规范抗结核治疗，术前纠正患者基础疾病及营养不良状态，选择合适的手术时机、术中彻底清除病灶，重建脊柱的稳定性是提高治愈率，降低复发率重要环节之一。
Abstract:
Objective:To explore the diagnosis,treatment and prognosis of patients with spinal tuberculosis,and to improve the curative effect of patients with spinal tuberculosis.Methods：The clinical and followup data of 330 patients with spinal tuberculosis were retrospectively analyzed.Results:The shortest antituberculosis period of 330 patients before operation was 3 weeks,and the longest antituberculosis period was 7 weeks.The shortest antituberculosis period after operation was 12 months,and the longest was 24 months.There were 6 cases of cervical spine tuberculosis,75 cases of thoracic spinal tuberculosis,99 cases of thoracolumbar spinal tuberculosis,104 cases of lumbar spinal tuberculosis and 46 cases of lumbosacral spinal tuberculosis.There were 231 cases of anterior fixation and 99 cases of posterior fixation.The patients were followed up for more than 12 months before and after operation.There was no loosening,fracture or prolapse of spinal internal fixation,and bone fusion was achieved at the bone graft site.Preoperative spinal nerve function was graded according to Franckel spinal cord injury,including 0 case of grade A,6 cases of grade B,15 cases of grade C,24 cases of grade D,and 285 cases of grade E.All patients recovered to grade E after operation.The Cobb angle of the sagittal plane of the tuberculosis vertebral body decreased from (28.3±4.7)° before operation to (11.32±2.65)° after operation.The treatment effect was excellent in 256 cases (77.58%) and good in 74 cases (22.42%).Conclusion:Reasonable preoperative and postoperative,standardized antituberculosis treatment,preoperative correction of basic diseases and malnutrition,selection of appropriate surgical timing,complete removal of lesions during surgery,and reconstruction of spinal stability are one of the important links to improve the cure rate and reduce the recurrence rate.

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备注/Memo

备注/Memo:
陕西省卫生健康科研基金资助项目（2021D027）
更新日期/Last Update: 2026-04-05