病灶清除植骨联合外固定治疗腕关节结核的疗效分析

doi:10.3969/j.issn.1000-6621.2019.12.005

摘要/Abstract

摘要：

目的分析病灶清除植骨联合外固定治疗腕关节结核的疗效。方法回顾性分析2016年1月至2019年1月青海省第四人民医院和首都医科大学附属北京胸科医院收治的32例腕关节结核患者,其中17例实施常规腕关节病灶清除术治疗,作为对照组;15例实施病灶清除植骨联合外固定术治疗,作为观察组。对比分析两组患者治疗后腕关节功能优良率、视觉模拟评分量表(VAS量表)评分、生命质量量表(QOL)评分改善情况,以及并发症发生情况。结果治疗1个月后,观察组腕关节功能优良率为93.3% (14/15),明显高于对照组的58.8% (10/17);VAS评分为(1.21±0.13)分,明显低于对照组的(3.18±0.49)分;并发症发生率为6.7% (1/15),明显低于对照组的41.2% (7/17),差异均有统计学意义(χ ²=5.06,P=0.024;t=15.08,P<0.001;χ ²=4.75,P=0.029)。治疗3个月后,观察组QOL评分为(50.14±3.52)分,明显高于对照组的(41.01±1.57)分,差异有统计学意义(t=9.67,P=0.000)。结论病灶清除植骨联合外固定术可有效改善腕关节结核患者腕关节功能,减轻疼痛感,降低并发症发生率,提升患者生存质量。

关键词: 结核, 骨关节, 腕关节, 外科手术, 选择性, 疗效比较研究

Abstract:

Objective To analyze the effectiveness of debridement and bone grafting combined with external fixation for the treatment of wrist joint tuberculosis.Methods A total of 32 patients with wrist joint tuberculosis who admitted to the Fourth People’s Hospital of Qinghai Province and the Beijing Chest Hospital of Capital Medical University from January 2016 to January 2019 were retrospectively analyzed. Among these patients, 17 cases were treated with conventional wrist joint debridement as a control group; and 15 cases were treated with debridement and bone grafting combined with external fixation as the observation group. The excellent rate of wrist function after treatment, the score of visual analog scale (VAS scale), the improvement of the quality of life scale (QOL) score, and the incidence of complications were compared between two groups.Results After 1 month of treatment, the excellent rate of wrist function in the observation group was 93.3% (14/15), which was significantly higher than that in the control group (58.8%, 10/17), with the statistically significant difference (χ ²=5.06, P=0.024); the VAS score of the observation group was (1.21±0.13), which was significantly lower than that of the control group (3.18±0.49), with the statistically significant difference (t=15.08, P<0.001); and the complication rate was 6.7% (1/15) in the observation group, which was significantly lower than that in the control group (41.2% (7/17)), with the statistically significant difference (χ ²=4.75, P=0.029). After 3 months of treatment, the QOL score of the observation group was (50.14±3.52), which was significantly higher than that of the control group (41.01±1.57), and the difference was statistically significant (t=9.67, P=0.000). Conclusion Debridement and bone grafting combined with external fixation can effectively improve the wrist function of patients with wrist joint tuberculosis, reduce pain, reduce the incidence of complications and improve the quality of life.

Key words: Tuberculosis, osteoarticular, Wrist joint, Surgical procedures, elective, Comparative effectiveness research

徐尚胜,秦世炳,范俊,霍永超,白生录,王春伟. 病灶清除植骨联合外固定治疗腕关节结核的疗效分析[J]. 中国防痨杂志, 2019, 41(12): 1258-1262. doi: 10.3969/j.issn.1000-6621.2019.12.005

Shang-sheng XU,Shi-bing QIN,Jun FAN,Yong-chao HUO,Sheng-lu BAI,Chun-wei WANG. Therapeutic effect of debridement and bone grafting combined with external fixation for the treatment of wrist joint tuberculosis[J]. Chinese Journal of Antituberculosis, 2019, 41(12): 1258-1262. doi: 10.3969/j.issn.1000-6621.2019.12.005

图/表 2

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组别	优	良	中	差
观察组(15例)	5(33.3)	9(60.0)	1(6.7)	0(0.0)
对照组(17例)	3(17.6)	7(41.2)	5(29.4)	2(11.8)

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