CAJ | 학술논문

目的：总结骶骨肿瘤术后伤口相关并发症类型及相应危险因素，探讨骶骨肿瘤并发症的预防及处理，为降低骶骨肿瘤手术并发症的发生率提供依据。方法：对1997年8月至2008年6月进行手术切除的302例骶骨肿瘤患者进行回顾性研究，总结骶骨肿瘤术后常见并发症的类型、相关危险因素及相应处理措施。结果：骶骨肿瘤患者术后最常见的并发症为切口不愈合、切口感染、脑脊液漏及内脏损伤及术后大出血。切口局部发生延迟愈合的46例，占15．2％。切口感染31例，占10．3％，内脏损伤12例，占4．0％。术后伤口不愈合、术后伤口感染及内脏损伤的主要危险因素包括肿瘤直径＞10cm、二次手术及放疗。术后11例患者出现大出血，其中7例患者经介入治疗病情稳定，2例患者伤口加压包扎，加快输血，病情稳定，2例患者术后出现多脏器功能衰竭而死亡。1例患者术后出现多发内脏转移及骨转移死亡。结论：充分了解骶骨肿瘤患者的手术风险因素有助于判断术后的情况，术前积极的防范及术后有效的预防及处理可以降低手术的风险。
목적：총결저골종류술후상구상관병발증류형급상응위험인소，탐토저골종류병발증적예방급처리，위강저저골종류수술병발증적발생솔제공의거。방법：대1997년8월지2008년6월진행수술절제적302례저골종류환자진행회고성연구，총결저골종류술후상견병발증적류형、상관위험인소급상응처리조시。결과：저골종류환자술후최상견적병발증위절구불유합、절구감염、뇌척액루급내장손상급술후대출혈。절구국부발생연지유합적46례，점15．2％。절구감염31례，점10．3％，내장손상12례，점4．0％。술후상구불유합、술후상구감염급내장손상적주요위험인소포괄종류직경＞10cm、이차수술급방료。술후11례환자출현대출혈，기중7례환자경개입치료병정은정，2례환자상구가압포찰，가쾌수혈，병정은정，2례환자술후출현다장기공능쇠갈이사망。1례환자술후출현다발내장전이급골전이사망。결론：충분료해저골종류환자적수술풍험인소유조우판단술후적정황，술전적겁적방범급술후유효적예방급처리가이강저수술적풍험。
Objective:To discuss the prevention and treatment for complications of sacral tumor and to provide the basis for reducing the incidence of complications .Method:302 patients with sacral tumor who received the resection treatment from August 1997 to June 2008 were retrospectively studied , and sacrum tumor complication types , related risk factors and treatment measures were summarized .Result: The most common postoperative complications for patients with sacral tumor included the disunion of incision , the in-fection of incision , cerebrospinal fluid leakage , viscera injury and postoperative massive hemorrhage .The number of patients whose incision was disunited locally was 46 cases ( accounting for 15.2%);the number of patients whose incision was infected was 31 cases ( accounting for 10.3%);the number of patients whose vis-cera was injured was 12 cases ( accounting for 4.0%) .The major risk factors for the disunion of incision , the infection of incision and viscera injury after the operation included a tumor whose diameter was more than 10 cm, a secondary surgery and radiotherapy .The number of patients who had a postoperative massive hemor-rhage was 11 cases, among whom, 7 patients were kept in a stable condition with interventional therapy;2 patients were kept in a stable condition by having compression bandage on the wound and accelerating the blood transfusion;2 patients suffered the function failure of multiple organs and died;1 patient suffered from multiple visceral metastasis and bone metastasis and then died .Conclusion:To fully grasp the risk factors for patients with sacral tumor surgery will help to determine the situation after the surgery , preoperative positive prevention , postoperative effective prevention and treatment will reduce the surgery risks .