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1、布魯氏菌性脊柱炎與結(jié)核性脊柱炎診斷的對比分析ComparetiveAnalysisOfTheDiagnosisOfBrucellarandTurberculousSpondylodiscitis作者姓名:董帥領(lǐng)域(方向):外科學(xué)指導(dǎo)教師:白云深教授類別:臨床醫(yī)學(xué)碩士答辯日期:2015年5月28日中文摘要目的:本研究旨在通過對布魯氏菌性脊柱炎與結(jié)核性脊柱炎的臨床表現(xiàn)、實驗室檢查以及MRI影像學(xué)檢查的比較,發(fā)現(xiàn)兩種疾病的不同點,以提高對于這兩種間盤炎性疾病的鑒別診斷水平,在最終檢驗結(jié)果得出之前對患者進行正確的初步診斷以及早期干預(yù)。材料與方法:本研究選取41
2、名診斷為脊柱炎的患者。其中,布魯氏菌性脊柱炎的患者18名(43.9%),結(jié)核性脊柱炎患者23名(56.1%)。將患者分為兩組,即布魯氏菌性脊柱炎組(BS組),結(jié)核性脊柱炎組(TS組)。將兩組患者的臨床癥狀和體征、實驗室檢查結(jié)果及MRI影像學(xué)檢查進行對比分析。結(jié)果:結(jié)核性脊柱炎患者的平均年齡(51.55±13.28歲)要大于布魯氏菌性脊柱炎患者的平均年齡(40.53±13.43歲)(P<0.001)。結(jié)核性脊柱炎的先發(fā)癥狀更明顯,并且血沉、C反應(yīng)蛋白的改變更顯著。結(jié)核性脊柱炎對椎體前側(cè)的破壞更強,并且更易發(fā)生腰大肌膿腫。結(jié)論:布魯氏菌性脊柱炎與結(jié)核性脊柱
3、炎在臨床癥狀、實驗室檢查以及影像學(xué)檢查中有一些差別,盡管臨床數(shù)據(jù)本身并不能完全區(qū)分布魯氏菌性脊柱炎與結(jié)核性脊柱炎,但是椎體的骨質(zhì)破壞的部位,有無腰大肌膿腫,ESR水平的高低,全身癥狀的表現(xiàn)可以使我們更容易區(qū)分這兩種疾病。這些不同點可以幫助我們更快、更準(zhǔn)確的診斷這兩種疾病,減少誤診,在最短的時間內(nèi)給予患者最有效的治療。關(guān)鍵詞:布魯氏菌性脊柱炎結(jié)核性脊柱炎臨床表現(xiàn)IAbstractObjective:ThisstudywasdesignedtoBrucellaspondylitistuberculousspondylitisandclinicalmanif
4、estations,laboratorytestsandcomparingMRIimagingfounddifferencesbetweenthetwodiseases,inordertoimproveforbothdiscinflammationdifferentialdiagnosisofthedisease,beforethefinaltestresultsobtainedinpatientswithproperinitialdiagnosisandearlyintervention.MaterialsandMethods:Thisstudyse
5、lected41patientsdiagnosedwithspondylitis.Amongthem,thepatientBrucellaspondylitisin18(43.9%),tuberculousspondylitispatients23(56.1%).Thepatientsweredividedintotwogroups,namelyBrucellaspondylitisgroup(BSgroup),tuberculousspondylitisGroup(TSGroup).Comparisonofthetwogroupsofpatients
6、withclinicalsymptomsandsigns,laboratoryfindings,andMRIimagingperformed.Results:Theaverageageofpatientswithtuberculousspondylitis(51.55±13.28years)isgreaterthantheaverageageofBrucellaspondylitispatients(40.53±13.43years)(P<0.001).Tuberculousspondylitisstartingmoresymptomaticandch
7、angeerythrocytesedimentationrate,C-reactiveproteinismorepronounced.Tuberculousspondylitisdamagetotheanteriorsideofthestrongerandmorelikelypsoasabscess.Conclusion:BrucellaspondylitistuberculousspondylitisandthereareIIsomedifferencesintheclinicalsymptoms,laboratorytestsandimagingt
8、ests,althoughtheclinicaldataitselfdoesnotfullyd