直肠癌手术致骶前静脉损伤大出血的处理

The management of the bleeding caused by the injury of the pre-sacral vein in the operation of rectal carcinoma

目的 探讨直肠癌术中骶前静脉损伤出血的处理及预防措施。方法 回顾性分析10例直肠癌根治术中损伤骶前静脉致大出血病例。结果 10例中7例术中行纱布填塞压迫止血,3例行骶骨胛图钉按压法止血。10例患者术中止血效果满意,无术后再出血及死亡。结论 骶前纱布垫压迫,骶骨胛图钉按压法是术中骶前静脉损伤发生出血时行之有效的止血方法。直肠癌手术中应高度警惕。

Objective To investigate the treatment and prevention of the bleeding caused by the injury of the pre-sacral vein in the operation of rectal carcinoma. Methods From 1955 - 2000,10 cases massive bleeding of pre-sacral vein caused by the operation of rectal cancer were analyzed retraspectively. Results Among 10 cases, 7 stopped bleeding by filling the pre-sacral space with gauzes, 3 cases were by pressing drawing pin on the sacrum. The effects of stopped bleeding was safisfactory in 10 cases, and no bleeding again and no death after operation. Conclusion Filling the pre-sacral space with gauzes and pressing drawing pin on the sacrum are effective methods for the injury of the pre-sacral vein in operation of rectal carcinoma. It is important to keep alert and to prevent injuring the pre-sacral vein in the operation of the rectal carcinoma.