脊柱外科杂志
脊柱外科雜誌
척주외과잡지
JOURNAL OF SPINE SURGERY
2015年
1期
37-40
,共4页
孔金海%肖辉%孙正望%许炜%刘铁龙%宋滇文%严望军%钱明%杨成%杨兴海%吴志鹏%黄权%林在俊%钟南哲%肖建如
孔金海%肖輝%孫正望%許煒%劉鐵龍%宋滇文%嚴望軍%錢明%楊成%楊興海%吳誌鵬%黃權%林在俊%鐘南哲%肖建如
공금해%초휘%손정망%허위%류철룡%송전문%엄망군%전명%양성%양흥해%오지붕%황권%림재준%종남철%초건여
骶骨%脊椎肿瘤%伤后愈合%气囊阻塞%血管%栓塞,治疗性
骶骨%脊椎腫瘤%傷後愈閤%氣囊阻塞%血管%栓塞,治療性
저골%척추종류%상후유합%기낭조새%혈관%전새,치료성
Sacrum%Spinal neoplasms%Wound healing%Balloon occlusion%Blood vessels%Embolization,therapeutic
目的：探讨选择性靶血管栓塞与球囊阻断2种方式对骶骨肿瘤术后患者伤口影响的比较。方法将104例骶骨肿瘤患者随机分为2组，术前行选择性靶血管栓塞（ A组）53例，球囊导管腹主动脉阻断（ B组）51例，其中20例患者术前已经行放、化疗。记录各组患者术中出血量、手术时间、术后引流量，观察2组患者术后伤口愈合情况。结果2组患者术中出血量、术后引流量相比差异无统计学意义（P＞0．05），2组患者手术时间、引流时间相比差异有统计学意义（P＜0．05）。 A组皮肤红肿5例，愈合不佳8例，伤口窦道瘘口2例，皮肤坏死6例；皮肤大面积坏死2例；B组皮肤红肿1例，愈合不佳1例，伤口窦道瘘口1例；2组间比较，B组切口愈合不佳及皮肤坏死发生率高于A组，差异有统计学意义（ P＜0．05）。随访2组患者术后0．5、1、2年肿瘤复发率差异无统计学意义（ P＞0．05）。 A组术后1例死亡、1例发生骶神经损伤，3例出现大小便功能障碍；B组术后无死亡，1例发生一过性神经症状，1例发生排尿功能障碍，术后1年左右恢复。结论球囊腹主动脉阻断可有效地控制骶骨肿瘤切除术中出血，与选择性靶血管栓塞相比对伤口影响更小。
目的：探討選擇性靶血管栓塞與毬囊阻斷2種方式對骶骨腫瘤術後患者傷口影響的比較。方法將104例骶骨腫瘤患者隨機分為2組，術前行選擇性靶血管栓塞（ A組）53例，毬囊導管腹主動脈阻斷（ B組）51例，其中20例患者術前已經行放、化療。記錄各組患者術中齣血量、手術時間、術後引流量，觀察2組患者術後傷口愈閤情況。結果2組患者術中齣血量、術後引流量相比差異無統計學意義（P＞0．05），2組患者手術時間、引流時間相比差異有統計學意義（P＜0．05）。 A組皮膚紅腫5例，愈閤不佳8例，傷口竇道瘺口2例，皮膚壞死6例；皮膚大麵積壞死2例；B組皮膚紅腫1例，愈閤不佳1例，傷口竇道瘺口1例；2組間比較，B組切口愈閤不佳及皮膚壞死髮生率高于A組，差異有統計學意義（ P＜0．05）。隨訪2組患者術後0．5、1、2年腫瘤複髮率差異無統計學意義（ P＞0．05）。 A組術後1例死亡、1例髮生骶神經損傷，3例齣現大小便功能障礙；B組術後無死亡，1例髮生一過性神經癥狀，1例髮生排尿功能障礙，術後1年左右恢複。結論毬囊腹主動脈阻斷可有效地控製骶骨腫瘤切除術中齣血，與選擇性靶血管栓塞相比對傷口影響更小。
목적：탐토선택성파혈관전새여구낭조단2충방식대저골종류술후환자상구영향적비교。방법장104례저골종류환자수궤분위2조，술전행선택성파혈관전새（ A조）53례，구낭도관복주동맥조단（ B조）51례，기중20례환자술전이경행방、화료。기록각조환자술중출혈량、수술시간、술후인류량，관찰2조환자술후상구유합정황。결과2조환자술중출혈량、술후인류량상비차이무통계학의의（P＞0．05），2조환자수술시간、인류시간상비차이유통계학의의（P＜0．05）。 A조피부홍종5례，유합불가8례，상구두도루구2례，피부배사6례；피부대면적배사2례；B조피부홍종1례，유합불가1례，상구두도루구1례；2조간비교，B조절구유합불가급피부배사발생솔고우A조，차이유통계학의의（ P＜0．05）。수방2조환자술후0．5、1、2년종류복발솔차이무통계학의의（ P＞0．05）。 A조술후1례사망、1례발생저신경손상，3례출현대소편공능장애；B조술후무사망，1례발생일과성신경증상，1례발생배뇨공능장애，술후1년좌우회복。결론구낭복주동맥조단가유효지공제저골종류절제술중출혈，여선택성파혈관전새상비대상구영향경소。
Objective To evaluate the effect to incision of the selective target artery embolization and the abdominal aorta temporary balloon occlusion for blocking blood in sacrum tumor resection.Methods A total of 104 cases with sacrum tumor were divided into 2 groups randomly, 53 cases were adopted with target artery embolization preoperation( Group A) , while 51 cases used the temporary balloon occlusion of abdominal aorta to control the bleeding in operation( Group B) .The blood vol-ume, operation time, drainage were recorded.And 20 cases were performed with radiotherapy or chemotherapy before opera-tion.The heal of the incision were observed.Results The blood volume and drainage of 2 groups had no statistical signifi-cance(P>0.05).The operation time and drainage time of 2 groups had statistical significance(P<0.05).Five cases with inflammation, 8 cases with undesirable healing, 2 cases with sinus or orificium fistulae,6 cases with cutaneous necrosis and 1 case with large acreage of the skin were in Group A.One case with inflammation, 1 case with undesirable healing, 1 case was with sinus or orificium fistulae and 1 case with cutaneous necrosis were in Group B.Conpared with Group A, Group B had higher incidence rate of undesirable healing and cutaneous necrosis, the difference had statistical significance (P<0.05).The difference of recurrence rate in 0.5,1,2 years of 2 groups had no statistical significance(P<0.05).One dead case, 1 case with sacral nerve injured, 3 cases with dysfunction of the bowels were in Group A.No dead case was in Group B, 1 case was suffered with temporary nerve syptoms, 1 case was suffered with dysfunction of the urination and recovered in 1 year.Conclu-sion The temporary balloon occlusion of abdominal aorta can control the bleeding of the operation sufficially in the resection of the sacrum tumor.And it has less complication of the incision necrosis than the selective target artery embolization.
