腹主动脉球囊阻断在骶骨肿瘤手术治疗中的应用

Application of temporary balloon occlusion of the abdominal aorta during the removal of sacral tumors

目的探讨腹主动脉球囊阻断技术在骶骨肿瘤切除术中控制出血的应用价值。方法对6例骶骨肿瘤患者(巨细胞瘤4例和脊索瘤2例)术前经股动脉途径置入球囊导管于腹主动脉远端肾动脉开口以下,术中充盈球囊暂时阻断血流下切除肿瘤,每次阻断45min,需重复阻断时间隔10min;记录术中出血量,观察手术效果。结果6例均成功置入球囊,操作时间30～60min,术中累计阻断血流时间40～130min,术中出血800～2000ml(平均1350ml)。肿瘤均顺利切除,未发生急性肾功能不全等并发症。结论球囊导管置入术安全简单,暂时阻断腹主动脉血流切除骶骨肿瘤,可明显减少术中出血,提高手术安全性。

Objective To evaluate the value on temporary balloon occlusion of the abdominal aorta to decrease blood loss during the removal of sacral tumors. Methods Six patients with sacral tumors including giant cell tumor 4 and chordoma 2, were implanted balloon catheter in the abdominal aorta below the orifice of renal artery via femoral artery approach before surgical operation. The balloon was inflated every 45 minutes with 10 minutes of free interval during surgical operation. Blood loss was recorded and operation effect was observed. Results In interventional department every case needed about 30 - 60 minutes for successful placement of the balloon catheter before the surgical operation. The balloon was inflated for blood flow occlusion from 40 minutes to 130 minutes accumulatively and blood loss ranged from 800 ml to 2000 ml （mean 1350ml）during the surgical operation. All the tumors of 6 cases were removed successfully and without complications, including acute renal failure. Conclusions The temporary balloon occlusion technique is safe and simple ,which can make the removal of sacral tumors more safer with less blood loss.