- 期刊
Tuberculous Spondylitis: A Clinical Analysis
結核性脊椎炎：臨床分析
摘要
雖然全球性的肺結核病例數正逐漸下降，但結核性脊椎炎之發病率卻依然持平。在很多國家，結核性脊椎炎常造成不可逆之脊髓神經破壞，導致癱瘓，故對此疾病必須有所認識。本文收集27位經病理切片證實結核性脊椎炎之病例，加以整理其年齡、性別、病變部位、臨床徵候及生化檢查，作分析報告。27位病例平均年齡為52歲，男性為女性之2倍，病灶多分佈在胸椎下段及腰椎。臨床上以漸進性之背痛、敲痛及發燒最常見，有約四分之一病例合併肺結核，45％病例有脊髓或神經根症狀“所有病例皆有結核性發炎物不同程度之壓迫脊椎硬膜。PPD測驗有48％病例呈陽性反應，90％病例有紅血球沉澱速率異常，而白血球、紅血球及血紅素皆多呈正常值。因此，對漸進性背痛、敲痛、發燒之病例，必須警惕結核性脊椎炎之可能性，同時予以 PPD 測驗，胸及脊椎之 X 光檢查與紅血球沉澱速率檢查，以資幫助正確診斷。
關鍵字
無資料並列摘要
Twenty-seven tuberculous spondylitis patients were reviewed. Eighteen were men and 9 were women, the average age being 52 years. The lower thoracic and lumbar spines were involved most frequently. Fever, progressive pain over the involved spine and tenderness were common clinical manifestations. The neurological deficits were due to direct compression of neural structures by the inflammatory products. Elevated ESR and the Mantoux test were valuable indicators. About one-fourth of patients had coexisting pulmonary tuberculosis. Therefore, tuberculous spondylitis must be considered first in cases with progressive backache, tenderness, fever, elevated ESR and positive Mantoux test.
延伸閱讀
- Lo, Y. C., Lee, H. H., & Wu, S. S. (2009). 結核性脊椎炎以腰大肌膿瘍呈現. Formosan Journal of Surgery, 42(2), 100-105. https://doi.org/10.29833/FJS.200904.0006
- Chiu, C. K., Su, Y. J., Lai, H. M., Chen, C. J., & Cheng, T. T. (2010). 結核性脊椎炎回溯性的分析. Formosan Journal of Rheumatology, 24(1&2), 14-21. https://doi.org/10.6313/FJR.2010.24(1-2).03
- 趙顗絢（2014）。淺談結核性脊椎炎。台北市醫師公會會刊，58(7)，21-22。https://www.airitilibrary.com/Article/Detail?DocID=P20110322001-201407-201408110006-201408110006-21-22
- 楊榮森、曾永輝、吳振都、劉堂桂、侯書文（1992）。脊椎後側結核病：1病例報告。慈濟醫學雜誌，4(3)，191-195。https://doi.org/10.6440/TZUCMJ.199209.0191
- 黃乃炯、魏大森、陳威志（1994）。脊椎結核症病例報告。中華民國復健醫學會雜誌，22(1)，91-96。https://www.airitilibrary.com/Article/Detail?DocID=10253009-199406-22-1-91-96-a