脊柱转移瘤术前动脉栓塞研究进展  

Research progress on preoperative transarterial embolization in patients with spinal metastases

作　　者：蒋伟刚[1] 刘耀升[1] 刘蜀彬[1] 

机构地区：[1]安徽医科大学解放军307临床学院骨科,北京100071

出　　处：《中国骨与关节杂志》2015年第7期586-589,共4页Chinese Journal of Bone and Joint

基　　金：北京市科委首都临床特色课题<脊柱转移瘤硬膜外脊髓压迫症减压手术的预后因素分析>(z131107002213052)

摘　　要：动脉栓塞术最主要的目的是减少术中出血,还可栓塞肿瘤组织的血管,使肿瘤坏死溶解。目前,术前动脉栓塞术已被广泛应用于高血运脊柱肿瘤的治疗。动脉栓塞术不但可以作为减少手术出血的一种术前辅助措施,增加手术操作的可行性和安全性,使手术获得更好的疗效[1-3],而且在某些情况下,More than 60% of spinal metastases are hypervascular tumors.Intraoperative bleeding often occurred in the surgery for spinal metastases in the past.Therefore,it is necessary to take some preoperative interventions to reduce intraoperative bleeding.Preoperative embolization may be considered in order to decrease the risk of hemorrhage and improve the outcomes.Embolization in the patients with spinal metastases can be performed through the angiographic catheter.When such embolization is performed carefully,the complication rate becomes low.Preoperative transarterial embolization for hypervascular spinal tumors has been extensively used at present,and is considered to be a highly effective adjuvant technique in reducing intraoperative blood loss.Meanwhile,the feasibility and safety of the surgical procedure can be increased and better surgical outcomes can be achieved.Adequate embolization of tumor nutritious blood vessels and early surgery after embolization（ in hours） seem to determine the curative results of the procedure.Hypervascular spinal tumors are major indications of arterial embolization.One of the main contraindications of preoperative embolization for spinal metastases is a shared vascular pedicle between the anterior spinal artery and the quasi embolism.In general,embolization should be carried out within 72 hours before the surgery.The sooner the excision is performed,the less the blood loss is.After 72 hours,hemorrhage control is decreased due to arterial recanalization,arteriectasia or establishment of collateral circulation.In this paper,the indications and contraindications of preoperative transarterial embolization,the choice of emboliaztion agents,operation time,operation method,curative results and complications are reviewed.

关 键 词：止血技术 栓塞 治疗性 骨肿瘤 脊柱 出血 

分 类 号：R738.1[医药卫生—肿瘤]