彩色多普勒超声辅助低位腹主动脉球囊阻断术在骨盆或股骨肿瘤手术中的应用效果  

Application effect of color Doppler ultrasound-assisted low abdominal aortic balloon occlusion in operation of pelvic or femoral tumors

作　　者：邓继财[1] 周瑞仁[1] 唐小曼[1] 卢昭燚 李洁[2] DENG Ji-cai;ZHOU Rui-ren;TANG Xiao-man;LU Zhao-yi;LI Jie(Department of Anesthesiology,the First People′s Hospital of Nanning,Nanning 530000,China;Department of Ultrasound,the First People′s Hospital of Nanning,Nanning 530000,China)

机构地区：[1]广西南宁市第一人民医院麻醉科,南宁市530000 [2]广西南宁市第一人民医院超声科,南宁市530000

出　　处：《广西医学》2021年第8期953-956,961,共5页Guangxi Medical Journal

摘　　要：目的探讨彩色多普勒超声辅助低位腹主动脉球囊阻断术在骨盆肿瘤或股骨巨细胞瘤手术中的应用效果。方法15例骨盆肿瘤或股骨巨细胞瘤患者均在彩色多普勒超声辅助下行低位腹主动脉球囊阻断术治疗。记录患者的手术时间、球囊阻断时间、术中出血量、术中尿量、血制品输注情况等;比较患者腹主动脉球囊开放前、开放后5 min、开放后10 min的心率、平均动脉压变化情况,术前、腹主动脉球囊开放后1 h、术后24 h的动脉血pH值及乳酸,以及术前、术后24 h的肾功能指标。结果15例患者均顺利完成彩色多普勒超声辅助低位腹主动脉球囊阻断术,并完整切除肿瘤;手术时间为210.0(91.5)min,腹主动脉球囊阻断时间为69.0(39.5)min;术中尿量800.0(850.0)mL,术中出血量为800.0(1650.0)mL,12例患者术中接受输血治疗。术后72 h内患者均未出现穿刺点局部血肿、下肢血栓、动脉损伤、肾功能衰竭等情况。患者腹主动脉球囊开放前、开放后5 min、开放后10 min的平均动脉压差异无统计学意义(P>0.05),而腹主动脉球囊开放后5 min的心率较开放前上升(P<0.05),但开放10 min后心率与开放前差异无统计学意义(P>0.05);患者术前、腹主动脉球囊开放后1 h、术后24 h的动脉血pH值差异无统计学意义(P>0.05),而腹主动脉球囊开放后1 h、术后24 h的动脉血乳酸均高于术前(均P<0.05);患者术前与术后24 h的肾功能指标差异无统计学意义(P>0.05)。结论采用彩色多普勒超声引导下低位腹主动脉球囊阻断术治疗骨盆肿瘤或股骨巨细胞瘤,可减少术中出血量,缩短手术时间,对患者循环系统及肾功能影响较小。Objective To explore the application effect of low abdominal aortic balloon occlusion assisted with color Doppler ultrasound in pelvic tumor or femoral giant cell tumor surgery.Methods Fifteen patients with pelvic tumor or femoral giant cell tumor received low abdominal aortic balloon occlusion assisted with color Doppler ultrasound.The operation time,duration of balloon occlusion,intraoperative blood loss,intraoperative urine volume,and blood product infusion of the patients were recorded;a comparison was performed on changes in heart rate and mean arterial pressure before,five and 10 minutes after abdominal aortic balloon opening,arterial blood pH value and lactic acid before operation,one hour after abdominal aortic balloon opening and 24 hours after operation,as well as renal function indices before operation and 24 hours after operation.Results Color Doppler ultrasound-assisted low abdominal aortic balloon occlusion was successfully performed in 15 patients,and the tumor was removed completely,the operation time was 210.0(91.5)minutes,the duration of abdominal aortic balloon occlusion was 69.0(39.5)minutes,the intraoperative urine volume was 800.0(850.0)mL,the intraoperative blood loss was 800.0(1650.0)mL,and 12 cases received intraoperative blood transfusion therapy.No local hematoma in the puncture site,lower extremity thrombosis,artery injury or renal failure occurred in the patients within 72 hours after operation.There was no statistically significant difference in mean arterial pressure before and five and 10 minutes after abdominal aortic balloon opening(P>0.05),and heart rate increased five minutes after abdominal aortic balloon opening as compared with that before the opening(P<0.05),but heart rate 10 minutes after the opening did not statistically differ from that before the opening(P>0.05);no statistically significant difference was observed in arterial blood pH values before operation,one hour after abdominal aortic balloon opening and 24 hours after operation(P>0.05),whereas the arterial blood l

关 键 词：骨盆肿瘤 股骨巨细胞瘤 彩色多普勒超声 低位腹主动脉阻断术 球囊导管 止血 

分 类 号：R738.1[医药卫生—肿瘤]