肿瘤切除、残腔置管灌注化疗治疗骶骨肿瘤和高浓度化疗药物对马尾神经功能的影响

目的：观察局部灌注高浓度化疗药物对马尾神经功能的影响,探讨该方法在治疗骶骨肿瘤中的应用价值并介绍１５例高位骶骨肿瘤患者的治疗效果。方法：分别将浓度为２００,４００,８００及１２００ｍｇ／Ｌ的顺铂注入兔开放的骶管内,浸泡马尾神经６０ｍｉｎ,分别于浸泡前后观察兔体感诱发电位（ＳＥＰ）潜伏期及波幅的变化;１５例高位骶骨肿瘤患者均采取前后联合入路、肿瘤切除、残腔置管,术后第５天,采用化疗药物顺铂４００ｍｇ

Local chemotherapy of sacrum tumors after curettage and effects of highly concentrated anti-cancer chemical drugs on the function of cauda equina

AIM: To study the effects of anti-cancer chemicaldrugs with high concentration on the function of cauda equinaand to evaluate the "regional irrigating chemotherapy" in thetreatment of sacral tumors, especially those at high level ofthe sacrum. METHODS: Different doses of anti-cancerchemical drugs were irrigated respectively into opened sacralcanal of rabbits and, then cauda equina was immersed in thesolution of chemical drugs with high concentration for 6Ominutes. Semotosensory evoked potential (sep) was recordedbe fore and after the procedure. Fifteen patients with highlevel sacral tumors were treated by curettage through thecombined anterior and posterior approach, placing two plastictubes in the cavity after the removal of tumors. Cisplatin(4Oo mg/L~6OO mg/L) or carbonplatin (2 g/L) was irrigat-ed into the cavity through one plastic tube 5-day postopera-tively. Chemical drug was drained out through other tubes 6omin~ 12O min later. This procedure was repeated once a dayfor 1o days. RESULTS: The changes of latency and ampli-tude in the same group before and after chemical drug irriga-tion were not obvious, indicating that the procedure did notlead to detected injury of the nomal cauda equina. Out of the15 patients, only 1 had recurrence in the soft tissues and wastreated by thoroughly excision. in 3 other cases, the woundshealed after debridement. CONCLUSION: Regional irrigat-ing chemotherapy does not injury the cauda equina. Thismethod is safe and effective in the treatment of sacral tu-mors.