原发性骶骨肿瘤的手术治疗

Operative treatment of primary sacrum tumor

目的：了解手术治疗原发性骶骨肿瘤的疗效。方法：回顾分析１９８５年３月至１９９６年１０月手术治疗的原发性骶骨肿瘤２３例，包括良性肿瘤６例，恶性肿瘤１７例。病变位于Ｓ３以上者７例，Ｓ３以下者１６例。行全骶骨切除４例，次全骶骨切除１９例。结果：全部手术无一例死于术中。术后常见并发症为手术切口皮缘感染坏死、皮下血肿、脑脊液漏及大小便功能障碍。２１例平均随访３．８年，３例死于术后复发或转移，１６例能从事一般工作，２例能从事一般家务劳动。结论：做好详细的术前检查及周密的手术准备，术中尽量采用低温低压麻醉以减少出血量。

Objective:To evaluate the effect of surgical treatment of primary sacrum tumor.Method:23 cases of primary sacrum tumor were treated operatively from 1985 to 1996.Among all the tumors,6 cases belonged to benign tumors, while 17 malignant ones.The foci of 7 cases were above S 3 level,while 16 cases were below S 3.4 cases were given total sacrectomy while 19 cases subsacrectomy.3 cases had received a secondary operation because of local recurrence.[WTHZ]Result:None of the patients died intraoperatly.The common postoperative complications were the infection or necrosis of the skin incision margin,subcutaneous hematomas,CSF effusion and dysfunction of bowel and bladder movement.21 cases were followed with an average period of 3.8 years,among them 3 cases died because of recurrence or metastasis,16 cases restored their original work,2 cases could do house work.Conclusion:The detailed preoperative examination and preparation should be emphasized before operation.Adopting anesthesia combined with hypothermia and hypopiesia to reduce the bleeding volume in the operation and using various active procedures to prevent postoperative complications are the key points of a successful operation. Authors address\ Dept.of Orthopaedic,Affiliated Hospital of Medical College,Qingdao University,Shandong,266003