骶骨肿瘤术中4种控制出血方法临床效果评价  

Clinical evaluation of four methods to control bleeding during resection of sacrum tumor

作　　者：李世德[1] 尹文军[1] 

机构地区：[1]广西医科大学一附院脊柱骨病外科,广西南宁530021

出　　处：《实用肿瘤杂志》2011年第5期526-529,共4页Journal of Practical Oncology

基　　金：广西科学基金(桂科自0991113);广西医疗卫生科学研究基金(桂卫重200839)

摘　　要：目的探讨骶骨肿瘤术中应用髂内动脉结扎、术前介入靶血管栓塞、低位腹主动脉血管外阻断、未行控制出血4种方法控制出血的临床效果及其实用价值。方法回顾性分析84例骶骨肿瘤患者临床资料,根据术中控制出血方法的不同分为4组:髂内动脉结扎(A组)20例,术前介入靶血管栓塞(B组)11例,低位腹主动脉血管外阻断(C组)22例,未行控制出血的对照组(D组)31例。比较各组术中出血量、手术时间、术后住院天数、骶神经损伤、休克死亡等并发症。结果低位腹主动脉血管外阻断(C组)出血量最少([1788.64±523.48)mL],手术时间([163.18±21.13)分钟]和住院时间([12.81±2.19)天]最短,同时并发症发生率(1/22)最少;未行控制出血的对照组(D组)出血量最多([5068.54±1905.54)mL;]髂内动脉结扎(A组)和术前介入靶血管栓塞(B组)手术时间均较其他两组长。结论暂时性低位腹主动脉血管外阻断可有效控制骶骨肿瘤切除术中出血,减少手术时间,降低手术并发症,缩短住院时间,是一种安全、有效、经济的的方法。Objective To study the clinical effect and practical value of four methods to control bleeding during the resection of sacrum tumor,including target arterial embolization,internal iliac artery ligation,abdominal aorta block and non-vessel controlled. Methods The clinical data of 84 patients of sacrum tumor were retrospectively analyzed.All patients underwent surgery.Eighty-four patients with sacrum tumor were divided into 4 groups according to different methods to control bleeding： hypogastric artery ligation in 20 cases（Group A）,transcatheter arterial embolization before operation in 11 cases（Group B）,intermittent block of lower abdominal aorta in 22 cases（Group C）,and non-vessel controlled in 31 cases（Group D）.The different methods were compared according to complications such as the loss of blood,operation time,the days in hospital after operation,shock or death,sacral nerves injury. Results The least volume of bleeding was（1788.64±523.48）mL in Group C,operation time [（163.18±21.13）min] and the days in hospital after operation [（12.81±2.19）days] was the shortest in Group C;at the same time,Group C had the lowest incidence of complications of postoperation complications（1/22）.The highest volume of bleeding was（5068.54±1905.54）mL in Group D and the operation time in Group A and Group B was longer than that in other groups. Conclusions Intermittent block of abdominal aorta is effective in controlling the bleeding during the resection of sacrum tumor.It can reduce operation time and the days in hospital after operation and reduce surgical complications.The technique of intermittent block of lower abdominal aorta is an effective,secure and economical method for sacrum tumor.

关 键 词：骨肿瘤/外科学 骶骨 栓塞 结扎术 腹主动脉阻断 失血 手术 回顾性研究 

分 类 号：R738.1[医药卫生—肿瘤]