关键词: 结核, 骨关节, 引流术, 治疗结果

Abstract: OcjectiVe To compare the therapeutic effiects between multiple tube continuous closed drainage and simple drainage combined with focal debridement in treatment of early knee tuberculosis. Methods Clinical data of the patients were retrospectively analyzed. All cases got 2 -4 weeks of regular anti-tuberculosis drug treatment before surgery. ESR was controlled below 40mm/1h. All cases got surgery of debridement. According to different methods of drainage,the patients were divided into two groups:multiple tube continuous closed drainage and simple drainage,50 cases in the former group with drainage time for 3-6 weeks(average 3. 8 weeks),32 cases in the latter group with drainage time for 1-3 weeks(average 1. 8 weeks). Based on the drug sensibvivity test for anti-tuberculosis drugs, the therapeutic regimen should be modified for systemic and local administration. Liver function,renal function and blood routine,ESR,knee joint CT scan were observed on regular eXamination. Based on results,the therapeutic regimen was adjusted reasonably. The efficacy of knee tuberculosis was evaluated 12-24 months after surgery. Follow-ups included range of motion of knee,Lysholm score,healing of incision,interferon-gamma,ESR,CRP and others. Results Eighty-two cases of pathological report were tuberculosis. The follow-up period ranged from 24 -48 months( mean 41 months ). Interferon-gamma, ESR,CRP showed normal between 8-12 weeks after surgery. There were no recurrence cases. One sinuse was found in multiple tube continuous closed drainage group. Four sinuses were found in simple drainage group. They were all cured by changing dressing. Lysholm score of multiple tube continuous closed drainage group was(89. 2 ± 8. 4)scores at 12 months after surgery. Lysholm score of simple draingage group was( 89. 2 ± 8. 4 )scores,there was significant difference. Conclusion The multiple tube continuous closed drainage method in early knee tuberculosis was recommended as low recurrence rate, preserving the function of joint movement,strong operability,cheap price,easy application. The clinical effect was satisfied and had a good clinical application value.

Key words: tuberculosis, osteoarticular, drainage, treatment outcome