动脉栓塞对骨盆肿瘤手术疗效的影响

目的]探讨供血动脉栓塞对骨盆肿瘤手术疗效的影响。方法]本组16例，脊索瘤7例，骨巨细胞瘤3例，骨转移瘤3例，骨肉瘤2例，神经纤维瘤1例。术前1d行肿瘤血管造影并用明胶海绵进行供血动脉栓塞。与对照组（结扎双侧髂内动脉骨盆肿瘤切除术）比较，观察其对术中出血量、手术时间、住院时间、术后下床时间、伤口愈合时间及术后各种功能恢复的影响。结果]骨盆肿瘤切除术前肿瘤供血动脉栓塞与结扎双侧髂内动脉比较，除术中出血量外（P〉0．05），手术、住院、术后下床及伤口愈合时间在统计学上均有非常显著性差异（P〈0．001），而且结扎双侧髂内动脉可能对患者的性功能、排便功能等存在着不良的影响。结论]肿瘤供血动脉栓塞骨盆肿瘤切除术可大大缩短手术、住院、术后下床、伤口愈合时间，且能更好地保护盆腔内外各组织器官的血运，从而避免其功能的损害。

Clinical study of the operative effect by the blood supply arterial embolization in the pelvic tumor

Objective]To explore the operative effect by the blood supply arterial embolization in the pelvic tumor.Method]There were 16 cases included 7 chordomas,3 giant cell tumors of bone,3 mestastatic tumors,2 osteosarcormas,1 neurofibroma.The blood supply arterial embolization was performed through the angiography using the gelfoam one day before operation.Compared with the traditional ligating bilateral internal iliac arteries before the pelvic tumor excision.Observe on the blood loss during the operation,the times of operation,the times of hospitalization,the times of leaving sickbed after operation,the times of the healing wound and the effect of the functional recovery after operation.Result]Compare the ligating bilateral internal iliac arteries before the pelvic tumor excision with the blood supply arterial embolization before the pelvic tumor excision,except the blood loss during the operation(P> 0.05),the times of operation,hospitalization,leaving sickbed after operation and the healing wound had significant difference in statistics(P<0.001).And the ligating bilateral internal iliac arteries might have harmful effect on the defecation and sexual functions of the patients.Conclusion]The blood supply arterial embolization before the pelvic tumor excision can shorten the time of operation,hospitalization,leaving sickbed after operation,healing wound,and protecte the blood supply of all tissues inside and outside the pelvis,reduce the harm to the functions.