良性和恶性腹膜后肿瘤术前介入栓塞的临床应用  

Clinical application of preoperative interventional embolization for benign and malignant retroperitoneal tumor

作　　者：管阳[1] 刘凤永[1] 樊庆胜[1] 陈朔[1] 付金鑫 陈现现 

机构地区：[1]解放军总医院介入放射科,北京市100853

出　　处：《中国肿瘤临床》2017年第15期764-768,共5页Chinese Journal of Clinical Oncology

摘　　要：目的:评价良性、恶性腹膜后肿瘤术前介入栓塞的安全性及有效性,探讨腹膜后肿瘤供血动脉特点。方法:选取2008年6月至2015年6月解放军总医院收治的241例患者,分为良性腹膜后肿瘤组和恶性腹膜后肿瘤组。各组依据肿瘤长径分为A、B、C 3组,其中A组>10.0 cm,10.0 cm≥B组>5.0 cm,C组≤5.0 cm。比较各组患者的肿瘤体积、术中出血量、术中输血量、手术时间及术后住院天数差异性。统计其中70例术前介入栓塞腹膜后肿瘤的供血动脉情况。结果:良性肿瘤组A、B、C组手术时间、术中出血、术后住院天数比较,差异均无统计学意义(P>0.05)。恶性肿瘤组A、B组术中出血和术中输血比较,差异具有统计学意义(P<0.05)。腹腔腹膜后肿瘤的主要供血动脉为腰动脉、髂内动脉、肾上腺动脉、膈下动脉、肠系膜动脉分支,盆腔腹膜后肿瘤的主要供血动脉为髂内动脉分支。结论:术前介入栓塞能有效降低恶性腹膜后肿瘤外科术中出血风险、减少输血,提高患者围手术期安全性。良性腹膜后肿瘤未见显著效益,但可以为外科术前明确肿瘤供血情况。术前介入栓塞中重点为寻找腰动脉、髂内动脉、肾上腺动脉、膈下动脉、肠系膜动脉分支。Objective：Characteristics of the retroperitoneal tumor blood supply arteries were analyzed to evaluate the safety and effectiveness of preoperative interventional embolization for benign and malignant retroperitoneal tumors.Methods：A total of 241 cases were divided into benign retroperitoneal tumor group and malignant retroperitoneal tumor group.Each group was divided into groups A,B,and C according to the long diameter of the tumor tissue.Group A〉10.0 cm,5.0 〈cmgroup B ≤10.0 cm,and group C≤5.0 cm.Tumor volume,intraoperative blood loss,intraoperative blood transfusion,operation time,and hospitalization days were compared with 70 cases of preoperative interventional embolization of retroperitoneal tumor blood supply artery.Results：No significant difference in the operation time,intraoperative bleeding,and postoperative hospital stay was found in groups A,B,and C of the benign tumor group（P〈0.05）.Significant differences in intraoperative bleeding and intraoperative blood transfusion were found between groups A and B（P〈0.05）.Main arteries of the abdominal retroperitoneal tumor are the lumbar,internal iliac,and adrenal arteries.The main artery of pelvic retroperitoneal tumor is the internal iliac artery.Conclusion：Preoperative interventional embolization can effectively reduce the risk of bleeding during malignant retroperitoneal tumor surgery and improve the perioperative safety of patients.No significant benefit of benign retroperitoneal tumors and no increased risk of bleeding during surgery were observed.Retroperitoneal tumor preoperative embolization should focus on investigating the lumbar,internal iliac,and adrenal arteries.

关 键 词：术前介入栓塞 腹膜后肿瘤 外科手术 

分 类 号：R735.4[医药卫生—肿瘤]