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目的探讨布鲁氏杆菌性脊柱炎的诊断及治疗疗效。方法选择云峰医院2009年~2012年诊治的布鲁氏杆菌性脊柱炎患者18例,病变部位包括T12-L1:3例,L1:2例,L2-3:4例,L3-4:4例,L3-5:2例,L5-S1:2例,L4-S1:1例。18例患者中,保守治疗5例,使用多西四环素、利福平、链霉素联合用药;手术治疗13例,采取腰椎前路或后路病灶清除、髂骨取骨内固定。术后随访2年。结果全部患者均获得满意效果。保守治疗5例中有2例在剧烈劳动后会出现轻微下腰痛;手术患者植骨均融合,其中前路手术组有1例患者偶有午后低热、乏力;后路手术组中有1例患者残留轻微下腰痛伴有不同程度下肢不适。结论布鲁氏杆菌性脊柱炎通过合理选择治疗方案,单纯药物和药物联合手术均可取得满意疗效。
Objective To investigate the diagnosis and therapeutic effect of Brucella spondylitis. Methods 18 patients with Brucella spondylitis diagnosed and treated in Yunfeng Hospital from 2009 to 2012 were enrolled in this study. The lesions include T12-L1: 3 cases, L1: 2 cases, L2-3: 4 cases, L3-4: 4 Cases, L3-5: 2 cases, L5-S1: 2 cases, L4-S1: 1 case. Of 18 patients, conservative treatment in 5 cases, the use of docetaxel, rifampin, streptomycin combined treatment; surgery in 13 cases, to remove the anterior lumbar or posterior lesion, iliac bone fixation. Follow-up for 2 years. Results All patients were satisfied with the results. 2 cases of conservative treatment in 2 cases after severe labor there will be mild lower back pain; surgery patients with bone fusion, including anterior surgery group, 1 case of occasional afternoon fever, fatigue; posterior surgery group, 1 patient Minor lower back pain accompanied by varying degrees of lower extremity discomfort. Conclusion Brucella spondylitis through a reasonable choice of treatment options, simple drugs and drugs combined surgery can achieve satisfactory results.