骨盆肿瘤术前栓塞对骨科手术后切口愈合的影响  

Influence of preoperative embolization on incision healing after orthopedic surgery in patients with pelvic tumors: analysis of 119 cases

作　　者：刘向东[1] 赵家宁[1] 吴文娟[1] 张国川[2] 

机构地区：[1]河北医科大学第三医院放射科介入治疗室、河北省骨科生物力学重点实验室,石家庄050051 [2]河北医科大学第三医院放骨与软组织肿瘤科,石家庄050051

出　　处：《介入放射学杂志》2014年第4期340-342,共3页Journal of Interventional Radiology

摘　　要：目的探讨骨盆肿瘤术前栓塞对骨科手术后切口愈合的可能影响机制。方法收集2000年1月—2012年12月骨盆肿瘤患者119例,在骨盆肿瘤术前先行栓塞,观察骨科手术后切口愈合情况。119例中,65例栓塞材料以明胶海绵颗粒和明胶海绵条为主,为海绵组;54例栓塞材料以弹簧钢圈为主、明胶海绵条为辅,为钢圈组。分别统计两组骨科手术后发生切口延迟愈合及不愈合患者的例数,并比较组间差异有无统计学意义。结果骨科手术后,海绵组切口延迟愈合及不愈合11例,发生率为16.9%(11/65);钢圈组切口延迟愈合及不愈合2例,发生率为3.7%(2/54),组间差异有统计学意义(P<0.05)。结论末梢血管床的栓塞可能是骨盆肿瘤术前栓塞导致骨科手术后切口延迟愈合及不愈合的重要原因,通过改变栓塞材料有效的保护末梢血管床可以明显降低骨科手术后切口延迟愈合及不愈合的发生率。Objective To explore the possible mechanism of delayed wound healing and unhealed incision after orthopedic surgery in patients with pelvic tumor receiving preoperative embolization, and to discuss the methods to reduce the incidence of delayed incision healing and non-healing wounds. Methods A total of 119 patients with pelvic tumors, who were encountered at authors’ hospital during the period from Jan. 2001 to Dec. 2012, were collected for this study. Preoperative embolization was employed before orthopedic surgery. The wound healing condition after the surgery was retrospectively analyzed. Of 119 patients, gelatin sponge particles and strips used as main embolic material were employed in 65 （sponge group） and steel coils used as main embolic material together with sponge strips as supplementary embolization material were adopted in 54 （steel coil group）. The incidences of delayed wound healing and unhealed incision were calculated and the results were compared between the two groups. Results After the orthopedic surgery the incidences of delayed wound healing and unhealed incision in the sponge group and the steel coil group were 16.92%（11/65） and 3.70%（2/54） respectively, the difference between the two groups was statistically significant（χ2=4.025 6, P＆lt;0.05）. Conclusion The obstruction of peripheral vascular bed after preoperative embolization therapy may be an important factor that causes delayed wound healing and unhealed incision after orthopedic surgery in patients with pelvic tumor. The incidence of delayed wound healing and unhealed incision after orthopedic surgery can be significantly reduced by changing embolization materials to effectively protect the peripheral vascular bed.（J Intervent Radiol, 2014, 23：340-342）.

关 键 词：骨盆肿瘤 栓塞 切口愈合 末梢血管 

分 类 号：R738.1[医药卫生—肿瘤]