What to do if you have lumbar tuberculosis? This is the correct treatment

Lumbar tuberculosis is a type of lumbar disease. People with lumbar tuberculosis are prone to pain or soreness, and their bodies may become tired and have symptoms of coughing, especially at night when sleeping. There are many ways to treat lumbar tuberculosis, including drug therapy, such as ethambutol.

Lumbar tuberculosis treatment

1. Supportive care

Pay attention to rest, nutrition, and adequate daily intake of protein and vitamins. Rest in bed more often, and strictly follow the doctor's orders when necessary. People with anemia can be given blood tonics, and those with severe anemia or recurrent fever can be given small amounts of fresh blood intermittently. Antibiotics can be given during the acute phase of mixed infections.

2. Anti-tuberculosis drug therapy

Currently, isoniazid, rifampicin and ethambutol are the first-line drugs. Isoniazid and rifampicin are the drugs of choice. In order to improve the efficacy and prevent drug resistance caused by long-term use of single anti-tuberculosis drugs, combination therapy is currently advocated. The adult dose of isoniazid is 300 mg per day, taken orally in 3 divided doses, or taken once in the morning. Since bone and joint tuberculosis lesions have poor blood supply and slow drug penetration, the medication time should not be too short. It is generally recommended to take isoniazid orally for 2 years. The adult dose of rifampicin is 450 mg taken once in the morning. Rifampicin is toxic to the liver. Liver function should be checked 3 months after taking the drug, and a decision on whether to continue using rifampicin should be made based on the liver function status. The general duration of application of rifampicin is 3 months. Ethambutol has a significant inhibitory effect on Mycobacterium tuberculosis. It has a strong ability to penetrate into lesions, and the adult dose is 750 mg taken once. Ethambutol has occasionally been associated with optic nerve damage. Isoniazid + rifampicin, or isoniazid + ethambutol, isoniazid is generally recommended. For severe patients, three drugs can be used at the same time. For patients with tuberculosis who have obvious systemic symptoms and persistent fever, sodium p-aminosalicylate or amikacin can be injected intravenously. The dose of sodium para-aminosalicylate is 12 g per day, injected intravenously in a dark environment; the dose of amikacin is 1 g per day. Because of toxic reactions, intravenous medication should be limited to less than 2 weeks. After treatment with anti-tuberculosis drugs, both systemic and local symptoms will gradually ease.

3. Local treatment

Use a plaster vest or brace (for upper lumbar tuberculosis) and a plaster waist belt with one leg (for lower lumbar tuberculosis). The fixation period is 3 months, and you should rest in bed more during the fixation period. If the patient is in poor general condition and cannot tolerate being immobilized, he or she can sleep on a specially made plaster bed for 3 months.

4. Surgery

There are three types of operations: ① Incision and drainage: When a cold abscess is widely discharged and secondary infection occurs, and the patient has obvious symptoms of systemic poisoning and cannot tolerate lesion clearance, incision and drainage can be performed to save his life. ② Lesion removal surgery for lumbar tuberculosis can be performed through an oblique incision or a midline incision in the lower abdomen, entering the lesion from the extraperitoneal space through the psoas major muscle abscess. Postoperative anti-tuberculosis drug treatment and local immobilization cannot be ignored. ③Corrective surgery to correct kyphosis.

Prognosis

Generally, after preoperative and postoperative anti-tuberculosis treatment, surgical lesion removal and internal fixation, bone healing can be achieved at the lesion site, the patient's symptoms disappear, and the patient is clinically cured.

prevention

1. Actively control infections in other parts of the body

2. BCG vaccination

Strict implementation of the BCG vaccination system has a definite effect on reducing the incidence of pulmonary tuberculosis and extrapulmonary tuberculosis in infants and children.

3. Prevention for contacts of tuberculosis patients

Patients with tuberculosis should follow the doctor's instructions and take medication regularly. Generally, the infectiousness will drop by 95% after 2 weeks of regular treatment. People who have been in contact with tuberculosis patients can go to a tuberculosis clinic for examination to rule out the possibility of the disease. At the same time, take the following preventive measures: Perform a thorough disinfection. According to the characteristics of Mycobacterium tuberculosis that it is resistant to cold and dry heat but not to wet heat, items used by patients, such as tableware, towels, clothes, handkerchiefs, and masks, should be boiled for 10 to 15 minutes; items that cannot be boiled in water, such as books, quilts, and synthetic clothing, can be exposed to the sun for 4 to 6 hours or disinfected with ultraviolet light for two hours. In addition, it can also be disinfected with disinfectants such as Lysol. Ultraviolet lamps can be used to disinfect the air in the room where the patient lives. Open windows regularly to ventilate and keep the indoor air fresh. According to statistics, if you ventilate the air once every ten minutes, 99% of the tuberculosis bacteria in the air can be blown away after 4 to 5 times. Cultivate good hygiene habits, such as implementing a separate food system, using washing utensils for each person, washing hands frequently, changing clothes frequently, and disinfecting regularly.