| Background:In developed countries and developed regions,the incidence of spinal tuberculosis has decreased significantly,but in areas with backward economic development,the incidence rate is still high due to lack of medical resources and weak medical concepts;Qinghai Province is a high-incidence area of ??spinal tuberculosis.It is also mainly concentrated in Tibetan areas.Due to the influence of food culture,customs and traditions,there are serious non-standard anti-tuberculosis treatment outside the hospital,resulting in some patients with tuberculosis recurrence,multi-vertebral tuberculosis and even severe complications such as paraplegia.Treatment brings a heavy financial burden to patients and the painful experience of multiple surgeries! Although the clinical efficacy of traditional and classic standardized treatment regimens has been recognized,its chemotherapy regimens have a long course of treatment,increased drug resistance,obvious adverse drug reactions,and poor patient compliance in Qinghai.It can be significantly improved,shorten the course of treatment,increase patient compliance,and reduce the side effects of chemotherapy drugs.Meta-analyses of existing experimental studies were carried out to draw conclusions.Objective : To evaluate the difference in efficacy between ultra-short-course chemotherapy and standard treatment in patients with thoracolumbar tuberculosis after surgery.Material and Methods: Search English databases: Pubmed,Cochrane library,Web of Sciencel,etc.and search Chinese databases: China National Knowledge Infrastructure(CNK1)database,Wanfang database,VIP database,etc.A comparative study on the efficacy of anti-tuberculosis treatment in patients after thoracolumbar tuberculosis surgery.The retrieval time was until February 1,2022.The main statistical indicators were:(1)Cobb angle after treatment,(2)Motor nerve ASIA score,(3)Sensory nerve ASIA score,(4)After treatment CRP comparison,(5)ESR comparison after treatment,(6)bone graft fusion rate,(7)comparison of incidence of adverse reactions of anti-tuberculosis drugs;all the retrieved studies were screened strictly according to the inclusion and exclusion criteria,the study quality was evaluated and the data was extracted,and the extraction results were used The Cochrane Collaboration recommended software Review Manager 5.3 statistical software for Meta-analysis.Results : A total of 12 studies were included in the analysis,all of which were retrospective non-randomized controlled studies,with a total of 2089 patients,of which 1083 patients received ultra-short-course chemotherapy after surgery,and 1006 patients received standard chemotherapy after surgery;Meta-analysis results showed:(1)Cobb angle(MD=-0.01,95%CI(-0.44,0.43),P=0.98),ESR(MD=-0.51,95%CI(-1.11,0.02),P=0.10),bone graft fusion rate(RR=1.01,95%CI(0.99,1.04),P=0.27),motor nerve ASIA score(MD=-0.01,95%CI(-0.83,0.82),P=0.99),the difference was not statistically significant(P>0.05);(2)CRP(MD=0.08,95%CI(0.00,0.16),P=0.04),sensory nerve ASIA score(MD=7.93,95%CI(6.03,9.83),P<0.00001),the difference was statistically significant(P<0.05),the standard chemotherapy group was better than the ultra-short-course chemotherapy group;(3)the incidence of adverse drug reactions(RR=0.41,95%CI(0.28,0.60),P<0.00001),with statistical significance(P<0.05),the ultra-short-course chemotherapy group was significantly better than the standard chemotherapy group.Conclusions : The efficacy of ultra-short-course chemotherapy in patients after thoracolumbar tuberculosis debridement is similar to that of standard chemotherapy,indicating that ultra-short-course chemotherapy is feasible after complete tuberculosis debridement and strict compliance with the indications of ultra-short-course chemotherapy.And it is significantly better than standard chemotherapy in reducing the occurrence of adverse drug reactions. |
PDF Full Text Request