经胸膜外内固定术与经胸内固定术治疗胸椎结核的临床疗效对比

吴兴林; 周焯家; 赵伟峰; 彭智; 罗刚

doi:10.11659/jjssx.12E024048

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经胸膜外内固定术与经胸内固定术治疗胸椎结核的临床疗效对比

临床研究 | 更新时间：2025-07-23

- 经胸膜外内固定术与经胸内固定术治疗胸椎结核的临床疗效对比
- Clinical efficacy comparison of extrapleural internal fixation and transthoracic internal fixation in the treatment of thoracic tuberculosis
- 局解手术学杂志 2025年34卷第7期页码：600-603
- 作者机构：
  
  贵州省人民医院脊柱外科，贵州贵阳 550002
- 作者简介：
  
  罗刚，E-mail：Porsche9968@163.com
- 基金信息：
  
  国家自然科学基金(82160419);贵州省卫生健康委科学技术基金(gzwkj2023-046)
- DOI：10.11659/jjssx.12E024048
  中图分类号： R681.5
- 收稿日期：2024-12-09，
  
  纸质出版日期：2025-07-25
- 稿件说明：
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吴兴林,周焯家,赵伟峰等.经胸膜外内固定术与经胸内固定术治疗胸椎结核的临床疗效对比[J].局解手术学杂志,2025,34(07):600-603.

WU Xing-lin,ZHOU Zhuo-jia,ZHAO Wei-feng,et al.Clinical efficacy comparison of extrapleural internal fixation and transthoracic internal fixation in the treatment of thoracic tuberculosis[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2025,34(07):600-603.
吴兴林,周焯家,赵伟峰等.经胸膜外内固定术与经胸内固定术治疗胸椎结核的临床疗效对比[J].局解手术学杂志,2025,34(07):600-603. DOI： 10.11659/jjssx.12E024048.

WU Xing-lin,ZHOU Zhuo-jia,ZHAO Wei-feng,et al.Clinical efficacy comparison of extrapleural internal fixation and transthoracic internal fixation in the treatment of thoracic tuberculosis[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2025,34(07):600-603. DOI： 10.11659/jjssx.12E024048.

摘要

目的

比较经胸膜外内固定术和经胸内固定术治疗胸椎结核的临床效果。

方法

纳入我院2018年6月至2023年6月收治的胸椎结核（T

）患者70例，对其临床资料进行回顾性分析，采用经胸膜外内固定术治疗的35例患者纳入经胸膜外组，采用经胸内固定术治疗的35例患者纳入经胸组。比较2组患者手术时间、术中出血量、植骨融合时间、手术前后窦角情况、术后疼痛视觉模拟量表（VAS）和腰痛Oswestry功能障碍指数（ODI）评分、术后并发症及复发情况。

结果

与经胸组比较，经胸膜外组患者手术时间、植骨融合时间缩短，术中出血量减少，差异均有统计学意义（

0.05）。2组患者术后窦角均较术前减小，且经胸膜外组患者术后窦角小于经胸组，差异均有统计学意义（

0.05）。术后7 d，经胸膜外组患者VAS评分低于经胸组，差异有统计学意义（

0.05）。术后1个月，经胸膜外组患者ODI评分低于经胸组，差异有统计学意义（

0.05）。经胸膜外组患者术后并发症发生率（0）低于经胸组（34.28%），差异有统计学意义（

0.05）。

结论

经胸膜外内固定术治疗胸椎结核时间短、出血少、创伤小，但难以彻底清除病灶；经胸内固定术可彻底清除病灶，但手术创伤较大。临床手术方案选择应根据患者具体病情、病灶部位、肺部情况等综合考虑，以达到最佳治疗效果。

Abstract

Objective

To compare the clinical efficacies of extrapleural internal fixation and transthoracic internal fixation in the treatment of thoracic tuberculosis.

Methods

A total of 70 patients with thoracic tuberculosis （T

to T

） who were admitted to our hospital from June 2018 to June 2023 were enrolled，and their clinical data were retrospectively analyzed.The 35 patients treated with extrapleural internal fixation were included i

n the extrapleural group，and the other 35 patients treated with transthoracic internal fixation were included in the transthoracic group.The operation time，intraoperative blood loss，bone graft fusion time，kyphotic angle before and after operation，visual analogue scale （VAS） and Oswestry disability index （ODI） scores after operation，postoperative complications and recurrence were compared between the two groups.

Results

Compared with the transthoracic group，the operation time and bone graft fusion time were significantly shortened，and the intraoperative blood loss was significantly reduced in the extrapleural group，with statistically significant differences （

0.05）.The postoperative kyphotic angles of the two groups were smaller than those before operation，the postoperative kyphotic angle of the extrapleural group was smaller than that of the transthoracic group，and the differences were statistically significant （

0.05）.The VAS score 7 days after operation of the extrapleural group was lower than that of the transthoracic group，and the difference was statistically significant （

0.05）.The ODI score 1 month after operation of the extrapleural group was lower than that of the transthoracic group，and the difference was statistically significant （

0.05）.The incidence of postoperative complications in the extrapleural group （0） was lower than that in the transthoracic group （34.28%），and the difference was statistically significant （

0.05）.

Conclusion

Extrapleural internal fixation has the advantages of short time，less bleeding and less trauma in the treatment of thoracic tuberculosis，but it is difficult to completely remove the lesions.Transthoracic internal fixation can completely remove the lesion，but the surgical trauma is large.The choice of clinical operation plan should be comprehensively considered according to the specific condition of the patients，the location of the lesion，and the condition of the lung，so as to achieve the best treatment effect.

关键词

Keywords

references

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