脊柱肿瘤全脊椎整块切除术围手术期并发症的处理  

Management of perioperative complications in total spinal resection of spinal tumors

作　　者：曾浩彬 朱小军[1] 唐清连 吴昊 徐怀远 卢金昌 王晋 ZENG Haobin;ZHU Xiaojun;TANG Qinglian;WU Hao;XU Huaiyuan;LU Jinchang;WANG Jin(Department of Bone and Soft Tissue Oncology,Sun Yat-Sen University Cancer Center,Guangzhou 510060,China;Department of Orthopedics NO.2(Spinal Surgery),Guangdong Hospital of Chinese Medicine,Zhuhai 519015,China)

机构地区：[1]中山大学肿瘤防治中心骨与软组织肿瘤科,广州510060 [2]广东省中医院珠海医院骨二脊柱科,珠海519015

出　　处：《中国癌症防治杂志》2020年第6期637-642,共6页CHINESE JOURNAL OF ONCOLOGY PREVENTION AND TREATMENT

基　　金：国家自然科学基金重大研究计划培育项目(91959115)。

摘　　要：目的探讨全脊椎整块切除术(total en bloc spondylectomy,TES)治疗脊柱肿瘤的围手术期并发症及治疗方法。方法收集2017年1月至2020年2月于中山大学肿瘤防治中心行TES治疗的32例脊柱肿瘤患者,观察术中及术后并发症发生及转归情况。结果32例患者均顺利完成手术,手术时间为(298.21±53.31)min(范围:260~380 min),术中出血量(2412.45±316.56)mL(范围:1850~3200 mL)。术后第1天,2例患者Frankel分级由术前E级加重至C级,3例患者由术前C级改善为D级,其余27例无变化。术前及术后患者的Frankel分级差异无统计学意义(Z=-1.526,P=0.075)。围手术期并发症总发生率为43.8%(14/32),均经对症处理后转归良好,无致死性并发症发生。结论脊柱肿瘤全脊椎整块切除术围手术期并发症发生率较高,及时有效处理均能缓解,致死性并发症发生率低。Objective To investigate the perioperative complications and treatment methods of total en bloc spondylectomy(TES)in the treatment of spinal tumors.Methods A total of 32 patients with spinal tumors,who received TES therapy in Sun Yat-Sen University Cancer Center from January 2017 to February 2020,were collected to observe the occurrence and outcome of intraoperative and post-operative complications.Results All the 32 patients completed the operation successfully.The operation time was(298.21±53.31)min(range:260-380 min),and the intraoperative blood loss was(2412.45±316.56)mL(range:1850-3200 mL).On the first day after the operation,the Frankel grade of 2 patients increased from preoperative Grade E to Grade C,3 patients improved from preoperative Grade C to Grade D,and the remaining 27 patients remained unchanged.There was no significant difference in Frankel classification between preoperative and postoperative patients(Z=-1.526,P=0.075).The total incidence of perioperative complications was 43.8%(14/32),all of which turned out to be good after symptomatic treatment and no fatal complications occurred.Conclusion The inci-dence of complications during the perioperative period of total spinal mass resection for spinal tumors is relatively high,which can be alleviated by timely and effective treatment,and the incidence of fatal complications is low.

关 键 词：脊椎肿瘤 外科手术 围手术期 并发症 

分 类 号：R738.1[医药卫生—肿瘤]