脊住肿瘤术前动脉造影和栓塞的临庆研究

目的通过选择性动脉造影了解脊住肿瘤的血管造影表现和血供情况，通过选择性动脉栓塞结果的评估探讨影响脊住肿瘤术前动脉栓塞和疗效的因素及并发症的防治措施。材料与方法45例脊住肿瘤行49例次DSA检查和术前迁择性动脉栓塞，男28例，女17例，平均御龄44.3岁(18～78岁);恶习性肿瘤35例,良性肿瘤10例.肿瘤位于骶尾部27例.胸椎7例.颈椎2例,行选择性血管造曩后用明胶海绵栓塞肿瘤供血动脉,于栓塞后1～5天内进行手术.结果①脊住肿瘤主要DSA表现为供血动脉不同程度增粗.不同程度的肿瘤染色.②49次SAE术共栓塞肿瘤血管115根,除2例因供血动脉发出脊髓根大动脉和1例存在多支血供而仅作部分栓塞者外余肿瘤血管均完全栓塞.③24例肿瘤完全切除,21例大部分切除,3例部分切除,1例未切除.④手术平均出血量为1009ml(400～2500ml),无1例发生术中死亡或术后亚重并发症.结论①脊住肿瘤详细的DSA检查有助于治疗方案的制定和所有靶血管的显示.②仔细分析DSA表现.改进栓塞技术是保证脊住肿瘤术前动脉栓塞疗效和养活产生并发症的关健。

The clinical study of SAand SAE for the preoperative treatment of spinal tumors

Objective：To evaluate DSA features of blood supply in spinaltumors,to investigate the complications of SAE and factors that influenced the result of spinal SAE.Materials and Methods：Forty nine DSA as well as SAE procedures in 45 cases of spinal tumors were performed with gelfoam one to five days before surgical operation.The tumors were located in cervical(2 patients),thoracic (9 patients),lumbar (7 patients) and sacrococcygeal vertebrae( 27 patients).Results:①Most tumors had the main DSA findings as enlargement of feeding arteries,obvious tumor stain,stricture and irregularity of vessels.②One hundred and fifteen feeding arteries were embolized.Forty eight cases had their masses resected with significant reduction of blood loss(average 1009ml),in 24 cases the tumors were resected completely,in 24 had partial resection of the tumor and in 1 case tumor failed to be resected due to intraoperative bleeding.There were no serious complications in all these cases.Conclusion:Meticulous analysis of DSA features is of utmost importance in the treatment of spinal tumors.The key point is to ensure satisfactory results and to reduce complications of the preoperative SAE procedures before tumor resection.