腹主动脉阻断与髂内动脉结扎控制出血在骶骨肿瘤切除手术中的应用比较研究

目的通过比较在骶骨肿瘤手术中应用腹主动脉阻断与髂内动脉结扎控制出血的临床统计学资料,探讨该两种方法在骶骨肿瘤手术中控制大量失血的实用价值.方法回顾性分析1992年～2002年间40例骶骨肿瘤切除手术中应用腹主动脉阻断方法19例,应用髂内动脉结扎21例以控制术中的大量失血.对两组病例的手术时间、术中失血量及术后并发症进行比较,两组资料应用统计学分析.结果在骶骨肿瘤切除手术中应用髂内动脉结扎21例,腹主动脉阻断19例,两者的手术时间和术后并发症无显著性差别,但术中失血量有明显差别,P＜0.05.结论在骶骨肿瘤切除手术中应用腹主动脉阻断比髂内动脉结扎技术更能有效控制术中失血量,而且并不会增加手术操作难度及延长手术时间.严格掌握阻断腹主动脉指征及阻断时间或结扎髂内动脉不会出现不可逆的缺血损害的并发症.我们认为在骶骨肿瘤切除手术中应用腹主动脉阻断对于控制术中失血优于髂内动脉结扎技术,但后者对减少术中失血也是一种有效方法,临床依术者及患者具体情况选择应用为宜.

A restrospective study of two surgical techniques in the treatment of sarum tumor abdominal--aorta block and internal iliac artery ligation

Objective:To compare clinical statistic data in the treatment of sacrum tumor by abdominal aorta block and internal iliac artery ligation, and evaluate the value in control of blood loss with the above two methods. Methods:Retrospective analysis 40 cases (19 cases with abdominal aorta block and 21 cases with double internal iliac artery ligation), statistic data including operative time, intra-operative blood loss,and postoperative complications. Results:There is no obvious difference in operative time and postoperative complications. But intra-operative blood loss volume by the method of abdominal aorta block is less than the method of internal iliac artery ligation (P<0.05). Conclusions: To control the intra-operative blood loss and less the operative time, either abdominal aorta block or internal iliac artery ligation is suitable, without serious complications. But the method of abdominal aorta block is superior to the internal iliac artery ligation in decreascing intra-operative blood loss. To select which method to control blood loss depends on actual statue.