高位骶骨肿瘤切除术中大出血的预防  

The prevention of hemorrhoea after superior position sacral tumor was resected

作　　者：王玉学[1] 刘贵秋[1] 

机构地区：[1]哈尔滨医科大学附属肿瘤医院骨科,黑龙江省哈尔滨150040

出　　处：《中国基层医药》2007年第9期1437-1438,共2页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的探讨预防高位骶骨肿瘤切除术中大出血的方法及效果。方法施行高位骶骨肿瘤切除手术36例,其中先经腹行双侧髂内动脉结扎14例,通过介入方法先行双侧髂内动脉暂时性栓塞7例,通过介入方法先行双侧髂内动脉永久性栓塞10例,通过介入方法于腹主动脉远端预先放置术中间断止血球囊5例,然后再经后路行高位骶骨肿瘤切除术;按预防大出血方法的不同计算各自术中平均出血量。结果经腹行双侧髂内动脉结扎者,术中出血量为500～2000ml,平均1100ml;通过介入方法先行双侧髂内动脉暂时性栓塞者,术中出血量为600～2100ml,平均1200ml;通过介入方法先行双侧髂内动脉永久性栓塞者,术中出血量为550～1900ml,平均1150ml;通过介入方法于腹主动脉远端预先放置术中间断止血球囊者,术中出血量为200～1000ml,平均560ml。结论上述暂时性或永久性减少骶部血供方法是可行的,完全可以预防高位骶骨肿瘤切除术中大出血,尤其是通过介入方法于腹主动脉远端预先放置术中间断止血球囊效果最佳。Objective To investigate methods and effect of preventing hemorrhoea when superior position sacral tumor was resected. Methods 36 patients with superior position sacral tumor were operated by excision of presacral tumor from May 2000 to May 2007.14 cases were performed with double hypogastric artery ligation. Hypogastric arteries were embolismed temporarily through intervention in 7 cases and permanently in 10 cases. Distal end of abdominal aorta was placed with sacculus in advance in 5 cases. Average volume of blood was Calculated ：according to different methods of preventing blood. Results Blood loss was 500 - 2000ml（average 1100ml） by hypogastric artery ligation. Blood loss was 600 - 2100ml（average 1200ml） by temporary double hypogastric arterial embolism while blood loss was 550- 1900ml （average 1150ml） by temporary embolism. Blood loss was 200 - 1000ml （average 560ml） by placing sacculus in advance at distal end of abdominal aorta. Conclusion Hemorrhoea may be prevented completely through temporarily or temporarily reducing blood supply of pars sacralis when sacral tumor was resected. Especially, it is a best method when distal end of abdominal aorta was placed with sacculus in advance.

关 键 词：骶骨肿瘤 手术并发症 出血 预防 

分 类 号：R738.1[医药卫生—肿瘤]