摘要
目的评价HIV/AIDS(Acquired Immunodeficiency Syndrome获得性免疫缺陷综合征)合并骨关节结核外科手术的治疗效果观察及评价。方法本院自2013年1月~2018年12月收治的HIV/AIDS合并脊柱结核并实施外科手术治疗的患者共15例,回顾性观察患者手术前后血红细胞沉降率(ESR)、C反应蛋白(CRP)变化、疼痛视觉模拟评分(visual analog scale,VAS)、Frankel分级(脊髓损伤严重程度的评定标准)改善情况、手术后伤口感染率、植骨融合时间、术后并发症、HIV/AIDS并发症、治疗前后T淋巴细胞亚群变化情况、术后住院日等指标。结果15名患者手术后切口均一期愈合无异常,仅有2名患者出现肺部感染,同时切口因脂肪液化延迟愈合,所有病例未出现严重并发症及机会性感染,无死亡病例,手术后出院时间(13.13±2.77天)和骨质融合时间(9.47±2.23月)上的差异没有统计学意义,手术前后血沉、CRP、VAS评分及CD4+T淋巴细胞等指标均有明细改善。结论合理的术前评估、围手术期抗结核治疗以及术后积极控制机会性感染,对HIV/AIDS合并脊柱结核的患者施行手术是安全可行的。
Objective To evaluate the therapeutic effect of surgical treatment of Acquired Immunodeficiency Syndrome(HIV/AIDS)combined with tuberculosis of bone and joint.Methods From January 2013 to December 2018,15 patients with HIV/AIDS and spinal tuberculosis were treated surgically in our hospital.The changes of ESR,CRP,visual analogue score of pain(VAS),Frankel’s grade(evaluation standard of spinal cord injury severity),infection rate of wound after operation,fusion time of bone graft,complications after operation,complications of HIV/AIDS,changes of T-lymphocyte subsets before and after treatment,hospital stay after operation were observed.Results 15 patients after surgery were primary healing of incision without exception,only 2 patients showed pulmonary infection,at the same time,incision delayed healing due to fat liquefaction,all cases without severe complications and opportunistic infections,no deaths,there was no significant difference in postoperative discharge time(13.13±2.77 days)and bone fusion time(9.47±2.23 months).The ESR,CRP,VAS score and CD4+T lymphocyte were improved in detail before and after operation.Conclusion Reasonable preoperative evaluation,perioperative anti tuberculosis treatment and postoperative active control of opportunistic infection are safe and feasible for patients with HIV/AIDS and spinal tuberculosis.
作者
马良
古甫丁
唐伟
地里下提·阿不力孜
MA Liang;GU Fuding;TANG Wei;DilixiatiAbulizi(Chest Hospital of Xinjiang Uygur Autonomous Region,Urumqi,Xinjiang 830049,China)
出处
《新疆医学》
2020年第5期437-440,共4页
Xinjiang Medical Journal
基金
新疆维吾尔自治区胸科医院科研项目(项目编号:2019005)
作者简介
马良,男,主治医师,研究方向:脊柱外科;通信作者:地里下提·阿不力孜,男,主任医师,研究方向:脊柱外科。Email:xkyy2011@126.com。
