低位腹主动脉球囊阻断下切除复发性骨盆肿瘤

目的介绍低位腹主动脉球囊阻断技术在控制复发性骨盆肿瘤术中出血的临床应用。方法2000年3月至2007年3月，作者应用低位腹主动脉球囊阻断技术对13例复发性骨盆肿瘤进行肿瘤切除骨盆环重建手术，采用1999年前有完整临床资料的26例以常规手术治疗的复发性骨盆肿瘤患者为对照，分析两组病例的手术时间、术中失血量、输血量及术后并发症。结果两组病人手术时间无明显差异，球囊阻断组术中失血量及输血量明显少于常规手术组（P〈0．05）。术后随访4个月至7年，常规手术组，4例患者发生肺转移死亡。9例局部复发，3例直肠损伤，1例膀胱损伤；球囊阻断组，1例发生肺转移死亡，所有病人均无邻近脏器损伤、肢体远端缺血坏死、肾功能损伤等并发症。结论在复发性盆腔肿瘤手术中应用低位腹主动脉球囊阻断技术能更有效地控制术中出血，使手术视野更加清晰，手术操作更方便，同时可以减少手术并发症，是一项有价值的临床技术。

Resection of Recurrent Pelvic Tumors by Technique of Lower Abdominal Aorta Balloon Block

Objective To discuss the clinical significance and experience of lower abdominal aorta balloon block in the operations of recurrent pelvic tumors. Methods From March 2000 to March 2007,13 patients with recurrent pelvic tumors were undergone tumor resection and pelvic ring reconstruction by technique of lower abdominal aorta balloon block. 26 recurrent pelvic tumors patients with integrate clinical data treated by normal operations before 1999 were enrolled as the control group. A comparative analysis was made between the two groups of operative time,intraoperative blood loss, blood transfusion, and postoperative complications. Results There is no obvious difference in operative time between two groups. But intraoperative blood loss and blood transfusion by technique of lower abdominal aorta balloon block is less than normal operation group. Patients were followed up for 4 months to 7 years. In control group,4 died of lung metastasis, 9 recurred, 1 rectum injury and 1 bladder injury. In aorta balloon block group, 1 died of lung metastasis. No damnification of adjacent organs or isehemic necrosis or failure of renal function happened. Conclusion In the operation of recurrent pelvic tumor,the use of lower abdominal aorta balloon block technique can reduce intraoperative blood loss ,which make the surgical field more clear and operation more convenient. It also can reduce the complications of operation,and is a valuable clinical technique.