原发性骶骨肿瘤的外科治疗

Surgical treatment of Primary Sacral Bone Tumor

目的介绍与探讨原发性骶骨肿瘤的临床表现,诊断及外科治疗.方法回顾我院1997年5月～2003年12月收治的18例原发性骶骨肿瘤患者,其中脊索瘤8例,骨巨细胞瘤5例,神经纤维瘤2例,动脉瘤样骨囊肿2例,骨肉瘤1例.均行手术切除,配合术后放疗或化疗,术后随访2～5年.结果 18例无术中死亡,16例功能恢复满意(88.9%),术后发生尿失禁、直肠损伤各1例,发生切口感染1例,术后复发3例(16.7%),术后5年内死亡2例(11.1%).结论积极手术切除是原发性骶骨肿瘤的有效治疗手段,充分的术前准备,正确判断术中出血,坚持后继治疗,可以提高患者的生存率.

Objective To study the diagnosis and surgical treatment of primary sacrum tumor. Methods 18 cases of primary sacrum tumor were treated from May 1997 to December 2003. Among all the tumors,there were 8 chordomas,5 giant cell tumor,2 neurofiboroma,2 aneurysmal bone cysts, 1 osteosacomas. All cases have been operated , combined radiotherapy and chemotherapy after operation,18 cases were followed up from 2 to 5 years. Results None of the patients died intraoperative. 16 cases revealed satisfactory functional results（88.9%）. There were injured rectums and urinary incontinence in 2 cases postoperative,respectively. 1 case resulted in the infection of the skin incision. 3 cases had postoperative recurrence（16.7%）. Two were died within 5 years（11.1%）. Conclusion Actively surgical removal is the effective means of treating primary sacrum tumor. Evaluating hemorrhage intraoperative correctly and persisting treatment postoperative can increase the living ratio.