靶血管栓塞后手术治疗脊柱骨巨细胞瘤的效果分析  

Surgical treatment of giant cell tumors of the spine after target arterial embolization

作　　者：周明[1] 杨惠林[1] 陈康武[1] 陆俭[1] 季一鸣[1] 胡海[1] 吴春屾[1] 陈超[1] 

机构地区：[1]苏州大学附属第一医院骨科,江苏苏州215006

出　　处：《中国医药导报》2013年第11期52-55,共4页China Medical Herald

摘　　要：目的探讨靶血管栓塞后手术治疗脊柱骨巨细胞瘤的临床疗效。方法回顾性分析1995年6月-2011年8月在苏州大学附属第一医院确诊为脊柱骨巨细胞瘤的28例患者的临床资料,其中骶骨15例,骶骨以上脊柱13例。所有患者术前均行靶血管栓塞,栓塞后1-2 d内手术。记录术中出血量、输血量,并观察术后神经功能及肿瘤复发情况。结果所有患者未出现栓塞并发症,肿瘤切除顺利,术中出血量400-5800 mL,平均1528.6 mL,输血量400-6000 mL,平均1514.3 mL。随访时间12-193个月,平均86.3个月,复发8例(28.6%),死亡2例(7.14%),6例(21.4%)出现伤口并发症,1例脑脊液漏,1例胸椎后凸畸形,24例(85.7%)患者术后神经功能正常。结论靶血管栓塞后手术治疗脊柱骨巨细胞瘤,能有效减少术中出血,有助于肿瘤彻底切除,减少手术并发症,是一项安全有效的技术。Objective To investigate the efficacy of surgical excision with preoperative transarterial embolization for the giant cell tumors of spine. Methods From June 1995 to August 2011, 28 patients with giant cell tumors of the spine were interviewed retrospectively. 15 in the sacrum and 13 in the mobile spine. All the patients were operated 1 to 2 days after transcatheter arterial embolization. The intraoperative blood loss and transfusion were reviewed. The local recurrence, complications, follow-up status and functional outcome were observed. Results There were no symptomatic complications associated with embolization. The average intraoperative blood loss was 1528.6 mL （range 400- 5800 mL）, and the average transfusion volume was 1514.3 mL （range 400-6000 mL）. The average follow-up was 86.3 months （range12-193 months）. Eight （28.6%） patients developed recurrence and two （7.14%） patients died. Six （21.4%） patients had wound complications, one patient experienced cerebrospinal fluid leakage and one thoracic patient developed kyphosis. Twenty-four （85.7%） patients retained normal neurologic function. Conclusion Preoperative embolization can significantly decrease intraoperative blood loss, and facilitate the maximal removal of the tumor. It is a safe and effective technique for excising giant cell tumors of the spine.

关 键 词：骨巨细胞瘤 脊柱 手术 栓塞 出血 

分 类 号：R738.1[医药卫生—肿瘤]