腹主动脉阻断联合内固定治疗高位骶骨肿瘤的临床观察

目的　探讨腹主动脉阻断联合内固定重建技术治疗高位骶骨肿瘤的临床疗效。方法　本院于２００６年１月至２００９年１２月收治３８例骶骨肿瘤患者，采用腹主动脉阻断下骶骨肿瘤切除＋骨水泥填充＋改良Ｇａｖｅｓｔｏｎ内固定技术重建。原发性肿瘤２９例，转移癌９例。肿瘤位于Ｓ１椎体１４例，Ｓ２椎体１２例，Ｓ１～Ｓ２椎体１２例。记录术中出血量、切口愈合、疗效、并发症以及随访情况。结果　手术时间３３０～４２０ｍｉｎ，手术出血量为（２４００±１６５６）ｍｌ，无术中死亡。术后患者腰骶部疼痛及神经功能有不同程度改善。７例术后出现排尿困难，半年后恢复；６例术后切口感染及延期愈合。术后随访６～３６个月，复发３例，死亡２例。１例脊索瘤患者术后半年复发，１例尤文肉瘤患者术后２月复发，１例转移癌患者３月复发。２例转移癌患者分别于术后１４个月、２０个月因全身衰竭而死亡。结论　腹主动脉阻断联合肿瘤切除＋骨水泥填充＋改良Ｇａｖｅｓｔｏｎ内固定技术是治疗高位骶骨肿瘤的有效手段，该术式可以减少出血，保证骶骨肿瘤切除，提高手术的安全性，有利于骨盆和脊柱的稳定性以及神经功能的恢复，术后可早期活动。

Clinical study of abdominal aorta blockage combined with internal fixation method on superior sacral tumors

Objective To investigate the efficacy of abdominal aorta blockage and the internal fixation method on superior sacral tumors.Methods From January 2006 to December 2009,38 patients with superior sacral tumor were underwent tumorectomy under abdominal aorta blockage plus bone cement implantation plus modified Gaveston technology,including 29 primary tumors and 9 metastasis cancers,and with 14 cases in S1,12 in S2,and 12 with S1-S2.Loss of blood,shock or death and sacral nerves injury were observed.Results The...