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中国防痨杂志 ›› 2020, Vol. 42 ›› Issue (6): 645-648.doi: 10.3969/j.issn.1000-6621.2020.06.021

• 经验介绍 • 上一篇    


鲍锐(), 刘晓阳, 任鹏, 张峰, 梁海燕, 王茹, 付玲, 甘地守   

  1. 550003 贵州省贵阳市公共卫生救治中心外一科
  • 收稿日期:2020-03-20 出版日期:2020-06-10 发布日期:2020-06-11
  • 通信作者: 鲍锐

Analysis of surgical treatment characteristics in patients with spinal tuberculosis and HIV co-infection

BAO Rui(), LIU Xiao-yang, REN Peng, ZHANG Feng, LIANG Hai-yan, WANG Ru, FU Ling, GAN Di-shou   

  1. Surgical Department, Public Health Treatment Center of Guiyang City, Guizhou Province, Guiyang 550003, China
  • Received:2020-03-20 Online:2020-06-10 Published:2020-06-11
  • Contact: BAO Rui


通过比较2013—2018年贵州省贵阳市公共卫生救治中心手术治疗的符合入组标准且确诊为脊柱结核并发HIV感染的5例患者(观察组)和与之性别、年龄、手术方式相匹配的5例单纯脊柱结核患者(对照组)的临床资料,初步探讨脊柱结核并发HIV感染者的手术治疗策略,发现观察组在术前评估和纠正CD4 +T淋巴细胞计数,术中严格遵守规范的消毒隔离程序和三级职业暴露防护原则(所有手术医护人员佩戴有防护眼镜的口罩,戴双层乳胶手套,穿一次性防水手术衣、袖套、靴套)基础下,两组患者在手术方式的选择、年龄、术中出血量,术后引流量、VAS评分等方面差异均无统计学意义(P值均>0.05);但观察组的平均手术时间[(3.0±0.9) h]高于对照组[(2.7±0.6) h](t=-0.424,P=0.004),并有1例患者出院1周时出现引流口窦道形成,经3个月扩创、换药、控制CD4 +T淋巴细胞计数达正常后逐渐愈合。

关键词: 结核, 脊柱, HIV感染, 共病现象, 外科手术, 治疗结果, 对比研究


A total of 5 patients with spinal tuberculosis (TB) and HIV co-infection (observation group) and 5 patients with spinal TB only (control group), who received surgical treatment in the Guiyang City Public Health Treatment Center of Guizhou Province from 2013 to 2018 and met the admission criteria, were enrolled into this study. The sex, age and operation methods of the patients in the observation group and control group were matched. The author compared the clinical data of the patients in both groups and to explore the surgical treatment strategy of the patients with spinal TB and HIV co-infection. It was found that, when the CD4 + T-lymphocyte count of the patients in the observation group was evaluated and corrected before the operation and the standardized disinfection and isolation procedures and the three-level occupational exposure protection principles (all surgical medical staff wore masks with protective glasses, double-layer latex gloves, disposable waterproof surgical clothes, sleeves and boots) were strictly adhered during the operation, there was no significant difference between the two groups in the selection of surgical methods, age, intraoperative hemorrhage, postoperative drainage, and VAS score (Ps>0.05). However, the average operation time in the observation group ((3.0±0. 9) h) was significant higher than that in the control group ((2.7±0. 6) h) (t=-0. 424, P=0. 004). One patient in the observation group appeared the drainage sinus in one week after discharged from the hospital and it gradually healed in 3 months of debridement, dressing change and control of CD4 + T-lymphocyte count.

Key words: Tuberculosis, spinal, HIV infections, Comorbidity, Surgical procedures, operative, Treatment outcome, Comparative study