手术联合超选择性动脉栓塞治疗异位骨化  

Super-selective arterial embolization plus surgical procedure for heterotopic ossification

作　　者：麦汉溪[1] 周正根[2] 张彦舫[1] 肖德明[1] 

机构地区：[1]暨南大学医学院附属第二医院,深圳市人民医院骨科,深圳518020 [2]广东省人民医院放射科

出　　处：《中华创伤杂志》2005年第6期420-423,共4页Chinese Journal of Trauma

摘　　要：目的根据创伤性异位骨化血管造影表现及供血特点,探讨超选择性动脉栓塞联合手术治疗异位骨化的有效性。方法随机选取25例异位骨化患者,12例给予手术+超选择性动脉栓塞(栓塞组),13例不予栓塞,按传统治疗方案在异位骨化成熟后给予手术切除(传统治疗组),比较两组手术中失血量、术后血红蛋白下降值、关节功能表现、复发率。结果12例患者血管造影显示,局部血管过度增生、微血管瘤形成是创伤性异位骨化形成和复发的病理基础。术中失血量栓塞组为(450±120)ml,与传统治疗组(800±130)ml比较,差异有统计学意义(P<0.01);术后血红蛋白下降值栓塞组与传统治疗组比较,差异有统计学意义(P<0.01);关节功能优良率栓塞组为83%,与传统治疗组46%比较,差异有统计学意义(P<0.05);1年复发率栓塞组为0,传统治疗组为15%(2例)。结论超选择性动脉栓塞联合手术治疗能够有效减少术中失血量,早期干预并提高异位骨化的治疗成功率,是一个有前景的治疗手段。Objective To observe the effect of preoperative super-selective arterial embolization (SSAE) plus surgical procedure for heterotopic ossification based on the angiographical features of heterotopic ossification. Methods A total of 25 cases with heterotopic ossification were randomly selected and treaued with SSAE plus surgical procedure (Group SSAE, 12 cases) and with traditional operation procedure (Group TOP, 13 cases) so as to compare relative indices including blood loss, ferrohemoglobin, joint function and recurrence rate in two groups. Results The angiograply of Group SSAE demonstrated local hypervascularization and microaneurysms that were pathological basis for heterotopic ossification formation. The intraoperative blood loss volume was (450±120) ml in Group SSAE and (800±130) ml in Group TOP, with statistically significant difference (P<0.01). Postoperative drop of hemoglobin was (20.0±8.0) g/L in Group SSAE and (4.5 ±4.0) g/L in Group TOP, with statistically significant difference (P<0.01). Joint function recovery rate was 83% in Group SSAE and 46% in Group TOP, with statistically significant difference (P<0.05). Recurrence rate was 0 in Group SSAE and 15% in Group TOP. Conclusions SSAE plus surgical procedure is a promising measure for the treatment of heterotopic ossification, for it can effectively reduce the intraoperative blood loss, early intervene and increase success rate of heterotopic ossification.

关 键 词：超选择性动脉栓塞治疗 异位骨化 联合手术治疗 血红蛋白下降 血管造影表现 治疗组 失血量 统计学 供血特点 手术切除 治疗方案 造影显示 过度增生 局部血管 病理基础 骨化形成 微血管瘤 关节功能 年复发率 早期干预 治疗手段 

分 类 号：R687[医药卫生—骨科学]