血管栓塞术在骶尾部骨肿瘤手术治疗中的应用

目的探讨血管栓塞术在骶尾部骨肿瘤手术治疗中的价值,指导临床骨肿瘤治疗方案选择。方法 2006年1月～2011年9月对47例骶尾部骨肿瘤患者手术前行血管栓塞术,观察患者的术前临床情况、手术相关指标和肿瘤相关指标以及并发症。并与对照组(选择同期165例未在术前行血管栓塞的骶尾部骨肿瘤切除术患者)结果相对比。结果术前血管栓塞治疗有效率达到100%,所有患者在接受血管栓塞治疗后并未感到明显疼痛;栓塞术中观察血管造影成像可见肿块染色程度较术前减少90%以上者达到100%;平均出血量为1 571.3 mL,平均手术时间为205.2 min。平均术后引流量为201.9 mL,与对照组相比均有明显减少。栓塞组中,肿瘤体积平均为376.2 cm3(对照组肿瘤体积为392.4 cm3),两组中肿瘤完全切除率均达100%。所有手术患者均未发生严重并发症。结论骨肿瘤切除术前常规行血管栓塞治疗,能极大程度上减少肿瘤血管供血,有利于完整切除肿瘤,提高手术成功率。

Application of vascular embolization in sacrum bone tumor surgery

Objective To guide the selection of clinical treatment strategy for bone tumor based on the observation of vascular embolization for sacrum bone tumor.Methods Forty-seven patients with sacrum bone tumors were subjected to vascular embolization in our hospital from Jan.2006 to Sept.2011.The preoverative clinical features,operation-related and tumor-related data and complications were observed.165 patients without receiving vascular embolization in the same period served as control group.Results Effective rate of preoperative vascular embolization was 100% with more than 90% of visible degree of tumor staining reduced.All patients had no side effects,the average blood loss was 1 571.3 mL,average operating time was 205.2 min,and mean postoperative drainage volume was 201.9 mL,which were significantly reduced as compared with the control group.Average tumor size in embolization group and control group was 376.2 cm3 and 392.4 cm3 respectively,and complete resection rate was 100% in both two groups.All surgical patients had no serious complications.Conclusion Vascular embolization before bone tumor operation routinely can greatly decrease the blood supply of tumor,favor the complete resection of tumor,and improve the success rate of surgery.