术前DSA在骶骨肿瘤外科治疗中的应用价值  

Preoperative embolization of sacrum tumor

作　　者：王季[1] 蔡郑东[1] 朱晓东[1] 李国东[1] 郑龙坡[1] 

机构地区：[1]第二军医大学附属长海医院骨科,上海200433

出　　处：《中国骨肿瘤骨病》2007年第2期96-98,共3页Chinse Journal Of Bone Tumor And Bone Disease

摘　　要：目的探讨术前DSA在骶骨肿瘤外科治疗中的应用价值。方法对1999年1月至2005年1月我科收治的50例骶骨肿瘤患者进行回顾性研究。50例患者均进行术前选择性动脉造影栓塞,局部化疗给药,栓塞后24～72h内进行肿瘤切除。结果50例肿瘤均获彻底切除,无手术中休克或死亡。术中出血大大减少,平均(2700±800)ml,术后5d引流量平均(580±220)ml。平均随访20个月(6～72个月),1例因一般情况较差死于围手术期并发症,骨肉瘤及转移癌及多发骨髓瘤均于术后6～18个月转移复发,1例脊索瘤及1例骨巨细胞瘤原位复发,余病例均无复发。结论术前DSA可以显示肿瘤的范围、肿瘤的血供、血管分布情况,提示肿瘤的性质,有助于术前的充分准备、手术入路的选择及术中肿瘤血管的处理。血管造影时的化疗给药是肿瘤切除术后化疗等综合治疗的有益补充,对提高肿瘤的治疗效果及预防术后复发具有一定的意义。因而,术前DSA是骶骨肿瘤外科治疗的十分有效的辅助治疗方法。Objective To evaluate the effect of preoperative transcatheter selective internal iliac artery embolization in the surgical treatment of sacrum tumors. Methods Based on a review of 50 patients with sacrum tumors. Selective internal iliac artery embolization with Gelfoam was performed in 50 patients and surgery was followed in 24 - 72 hours. Results 50 patients gained successful operation and there was no patient dead during operation and no other major complication. Tremendous reduction of blood loss during operation was noted in all embolization cases with an average of （2700ml ± 800ml ） blood loss during operation. The average follow-up is 20 months（6 - 72 months） and all osteosarcoma and multiple myeloma patients and one chordoma and one giant cell tumor were recurrence. Conclusions Preoperative transcatheter selective internal iliac artery embolization could demonstrate tumor area and the information of tumor vessels. Preoperative transcatheter selective internal iliac artery embolization is an effective adjuvant therapy for sacral tumorsand it could reduce intra-operative hemorrhage and render complete resection of a tumou possible.

关 键 词：骶骨 肿瘤 手术 数字减影血管造影 

分 类 号：R738[医药卫生—肿瘤]