在活体检查证明了活体成年脊柱结核病的手术指示的Delphi-based调查
K Venugopal Menon1, Saumyajit Basu2, Gauri Oka3
1Department of Orthopedics, Bharati Vidyapeeth Medical College Hospital, Pune, India.
Global spine journal
|September 30, 2023
概括
这个德尔菲调查建立了专家的共识在成人脊柱结核病 (TB) 的手术困境. 关键发现澄清了何时需要手术,强调神经学缺陷超过脊柱结核病治疗的其他因素.
科学领域:
- 整形外科 整形外科 整形外科
- 神经外科 神经外科
- 传染性疾病 传染性疾病
背景情况:
- 脊柱结核病 (TB) 提出了复杂的治疗挑战,特别是在成年患者的手术干预方面.
- 现有的指导方针在手术管理的关键决策点上提供了有限的共识.
研究的目的:
- 为了在成人脊柱结核病的手术治疗中的困境上达成专家共识.
- 为临床实践提供基于证据的建议.
主要方法:
- 一个多阶段的Delphi调查,涉及脊柱外科手术的关键意见领袖 (KOL).
- 文献审查,问题开发和三轮专家调查,共识值为70%.
主要成果:
- 在关于手术指标和管理的22个问题上达成共识.
- 绝对的外科指示包括在抗结核化疗 (ATT) 期间的神经缺陷进展.
- 只有在同时出现神经系统缺陷时才建议进行外周脱压;仅仅疼痛并不是一个迹象.
结论:
- 这项研究代表了第一个关于成人脊柱结核病的手术治疗的国家共识.
- 建议涉及血清学,放射学和临床方面,指导手术决策.
- 诸如ATT的持续时间,活跃的肺结核或耐药结核等因素被澄清为非初级手术指示.
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