脊柱肿瘤术前选择性动脉栓塞术的临床价值  

Clinical application of preoperative selective arterial embolization for spinal tumors

作　　者：王传卓[1] 刘兆玉[1] 王海瑞[1] 董德硕 Wang Chuanzhuo;Liu Zhaoyu;Wang Hairui;Dong Deshuo(Department of Radiology,Shengjing Hospital of China Medical University,Shenyang 110004,China)

机构地区：[1]中国医科大学附属盛京医院放射科,沈阳110004

出　　处：《中华放射学杂志》2020年第2期140-144,共5页Chinese Journal of Radiology

摘　　要：目的探讨脊柱肿瘤术前选择性动脉栓塞术的临床应用价值。方法回顾性分析2017年1月至2018年12月于中国医科大学附属盛京医院骨科行脊柱肿瘤切除手术的42例患者的临床资料,依据肿瘤切除术前是否行动脉栓塞治疗,将患者分为栓塞组(20例)和未栓塞组(22例),再根据手术方式分为椎体切除亚组和椎板切除亚组。栓塞组椎体切除12例、椎板切除8例;未栓塞组椎体切除13例、椎板切除9例。采用独立样本t检验比较各组间术中失血量、红细胞输入量、校准失血量、手术时间和住院时间的差异。结果栓塞组20例患者均成功实施了脊柱肿瘤动脉栓塞术,无严重并发症发生。栓塞组与未栓塞组患者术中失血量、红细胞输入量、校准失血量、手术时间和住院时间,差异均无统计学意义(P>0.05)。栓塞组椎体切除患者,术中失血量、红细胞输入量和校准失血量分别为(1966.7±898.8)ml、(7.42±3.27)U和(91.3±39.2)g/L,未栓塞组椎体切除患者分别为(2838.5±1143.5)ml、(11.04±4.08)U和(133.0±46.4)g/L,差异均有统计学意义(t值分别为-2.107、-2.436、-2.419,P<0.05);而2组手术时间和住院时间差异均无统计学意义(t值分别为-0.780、-0.549,P>0.05)。栓塞组与未栓塞组椎板切除患者的上述各指标差异均无统计学意义(P>0.05)。结论脊柱肿瘤术前选择性动脉栓塞术相对安全。脊柱肿瘤术前动脉栓塞不能减少外科切除手术的失血量,但对外科术式加以区分后,术前栓塞可显著减少接受椎体切除手术患者的失血量,而椎板切除手术的患者无明显受益。Objective To investigate the clinical value of preoperative selective arterial embolization for spinal tumors.Methods The clinical data of 42 consecutive patients who underwent spinal tumor resection in department of orthopedics Shengjing Hospital of China Medical University from January 2017 to December 2018 were retrospectively analyzed.Patients were divided into embolization group(20 cases)and non-embolization group(22 cases)according to whether they underwent arterial embolization before tumor resection.Two surgical treatments including vertebral resection and laminectomy were performed.The embolization group included 12 cases of vertebral resection and 8 cases of laminectomy;while the non-embolization group included 13 cases of vertebral resection and 9 cases of laminectomy.The difference of intraoperative estimated blood loss,total number of transfused packed red blood cell,calibrated estimated blood loss,operation time and hospitalization time were compared using independent sample t test.Results Twenty patients in the embolization group underwent successful interventional embolization without serious complications.There were no significant differences between the embolization group and the non-embolization group in terms of intraoperative estimated blood loss,total number of transfused packed red blood cell,calibrated estimated blood loss,operation time,and hospitalization time(P>0.05).Among the patients who underwent vertebral resection,intraoperative estimated blood loss,total number of transfused packed red blood cell and calibrated estimated blood loss were(1966.7±898.8)ml,(7.42±3.27)U and(91.3±39.2)g/L in the embolization group,and(2838.5±1143.5)ml,(11.04±4.08)U and(133.0±46.4)g/L in the non-embolization group,respectively,with statistically significant differences(t=-2.107,-2.436,-2.419,P<0.05).However,there was no significant difference in the operation time and hospitalization time between the two subgroups(t=-0.780,-0.549,P>0.05).Among the patients who underwent laminectomy,there were no si

关 键 词：肿瘤 脊柱 栓塞 治疗性 手术前期 失血 手术 

分 类 号：R73[医药卫生—肿瘤]