椎体肿瘤椎体重建术前选择性动脉栓塞临床应用研究  

The Clinical Study of Arteries Embolization Treatment Before Artificial Vertebral Body Replacement in Spinal Tumors

作　　者：黄益[1] 李耀国[1] 陈汉威[1] 武兴杰[2] 郭洲[2] 郝群禹[2] 黄希勤 

机构地区：[1]广州番禺区人民医院放射科,511400 [2]广东药学院附属第一医院,510080 [3]广东省东莞市清溪镇医院外科,523660

出　　处：《临床放射学杂志》2008年第12期1745-1748,共4页Journal of Clinical Radiology

摘　　要：目的探讨选择性动脉栓塞后肿瘤椎体切除重建的疗效及价值。资料与方法选择有脊髓压迫症状的胸腰椎肿瘤患者24例,分成对照组(n=11)和研究组(n=13)。对照组直接行肿瘤椎体切除人工椎体置换椎体重建术;研究组先行肿瘤供血动脉栓塞化疗后,再行肿瘤椎体重建术。结果对照组4例手术失败,7例手术成功,成功率57%,术中平均出血量为3385ml、平均手术时间5h;研究组13例肿瘤椎体全部手术切除成功,成功率达100%,术中平均出血量为842ml,平均手术时间3h。研究组与对照组比较术中平均出血量、手术时间差异有统计学意义(P<0.01)。所有患者随访6～36个月神经功能恢复满意,椎体重建稳定性良好。结论术前胸腰椎动脉栓塞便于肿瘤椎体切除及重建,可提高患者的生存质量。Objective To investigate the therapeutic effect of selective arteries embolization before Artificial vertebral body replacement in thoracic and lumbar spinal tumors. Materials and Methods 24 cases with thoracic and lumbar neoplasms were enrolled in our study. The patients were divided into control group（ n = 11, performed Artificial vertebral body replacement） and study group（ n = 13, performed selective arteries embolization before Artificial vertebral body replacement）. Results In control group, 4 operations were failed, 7 operations were succeeded, and successful ratio was 57%. The average estimated blood loss during surgery was 3385 ml for all 11 patients and average surgery time was 5h. In study group, 13 operations were succeed except 1 case who was dead after arterial embolism. The average estimated blood loss and average surgery time were 842ml and 3h. There were statistical significanees in average estimated blood loss and surgery time between two groups. 24 cases were followed up for 6 to 36 months. The surgeries were successful and their neural function recovered satisfactorily. The implanted vertebral bodies fused and the spinal stability was restored. Conclusion Preoperative vertebra arterial embolization can reduce bleeding during the operation.

关 键 词：选择性动脉栓塞 椎体肿瘤 人工椎体置换 椎体重建 

分 类 号：R738.1[医药卫生—肿瘤]