原发性骶骨肿瘤的外科治疗

Treatment of Primary Sacral Bone Tumor Surgical

目的 探讨原发性骶骨肿瘤的临床表现、诊断及外科治疗方法。方法 回顾1999年12月～2004年5月收治的24例原发性骶骨肿瘤患者，其中脊索瘤12例，骨巨细胞瘤7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，术后平均随访2．8年。结果 24例无术中死亡，20例功能恢复满意（83．3％），术后发生尿失禁直肠损伤各1例，术后复发4例（16．7％），术后5年内死亡4例（16．7％）。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 24 cases of primary sacrum tumor were treated from December 1999 to December 2004.May among all the tumors,there were 12 chordomas,7 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.20 cases revealed satisfactory functionalresults （83.3%）.There were injured rectums and urinary incontinencein 2 cases postoperative,respectively.3 cases had postoperative recurrence（16.7%）.Four were died within 5 years （16.7%）.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.