肿瘤血管栓塞在脊柱肿瘤手术治疗中的应用

Tumor vascular embolism applying to treatment of spinal tumor

目的 探讨术前栓塞肿瘤的供应血管后进行脊柱肿瘤切除手术的疗效。方法 应用数字减影血管造影X线机 (DSA)对脊柱肿瘤的主要供应血管进行栓塞 ,然后进行肿瘤的切除手术 ,自 2 0 0 1年 4月～ 2 0 0 2年 8月应用此方法治疗各类脊柱肿瘤共 14例 ,观察手术时间、出血量及手术疗效。结果 14例患者术中发现肿瘤表面供应血管大部闭塞 ,手术时间平均 170min ,平均出血量 72 0ml。经 18～ 36个月随访 ,1例转移性肺癌患者死亡 ,余患者随访时局部肿瘤未见复发 ,植骨融合良好 ,内固定物无松动及断裂。结论 术前行脊柱肿瘤的主要供应血管栓塞可以明显减少术中的出血量 ,提高肿瘤的彻底切除率。

Objective To study the advantage and curative effect of surgical management of spinal tumor after the tumor main vascular embolism.Methods 14 patients with spinal tumor were operated after the tumor main artery was embolized with DSA from April 2001 to August 2002.The operative time,amount of bleeding and curative effect were observed. Results The most tumor surface blood vessels were obliterated during the operation.The average operative time was 170 minutes and average amount of bleeding was 720 ml.The followup time was from 18 months to 36 months.The spinal tumor was not recurred except one patient with metastatic lung tumor was died in 13 months after the operation. The bone autograft was fused and the instrumentation was not loosed or broken. Conclusion The tumor main vascular embolism before the operation could decrease the amount of bleeding significantly and the exhaustive resection rate of the tumor was increased.