骶骨肿瘤伤口相关并发症的危险因素分析与对策

Analysis and Countermeasures to Risk Factors of Related Complications to the Wound of Sacral Tumor

目的:总结骶骨肿瘤术后伤口相关并发症类型及相应危险因素,探讨骶骨肿瘤并发症的预防及处理,为降低骶骨肿瘤手术并发症的发生率提供依据。方法:对1997年8月至2008年6月进行手术切除的302例骶骨肿瘤患者进行回顾性研究,总结骶骨肿瘤术后常见并发症的类型、相关危险因素及相应处理措施。结果:骶骨肿瘤患者术后最常见的并发症为切口不愈合、切口感染、脑脊液漏及内脏损伤及术后大出血。切口局部发生延迟愈合的46例,占15.2%。切口感染31例,占10.3%,内脏损伤12例,占4.0%。术后伤口不愈合、术后伤口感染及内脏损伤的主要危险因素包括肿瘤直径>10cm、二次手术及放疗。术后11例患者出现大出血,其中7例患者经介入治疗病情稳定,2例患者伤口加压包扎,加快输血,病情稳定,2例患者术后出现多脏器功能衰竭而死亡。1例患者术后出现多发内脏转移及骨转移死亡。结论:充分了解骶骨肿瘤患者的手术风险因素有助于判断术后的情况,术前积极的防范及术后有效的预防及处理可以降低手术的风险。

Objective：To discuss the prevention and treatment for complications of sacral tumor and to provide the basis for reducing the incidence of complications .Method：302 patients with sacral tumor who received the resection treatment from August 1997 to June 2008 were retrospectively studied , and sacrum tumor complication types , related risk factors and treatment measures were summarized .Result： The most common postoperative complications for patients with sacral tumor included the disunion of incision , the in-fection of incision , cerebrospinal fluid leakage , viscera injury and postoperative massive hemorrhage .The number of patients whose incision was disunited locally was 46 cases （ accounting for 15.2%）;the number of patients whose incision was infected was 31 cases （ accounting for 10.3%）;the number of patients whose vis-cera was injured was 12 cases （ accounting for 4.0%） .The major risk factors for the disunion of incision , the infection of incision and viscera injury after the operation included a tumor whose diameter was more than 10 cm, a secondary surgery and radiotherapy .The number of patients who had a postoperative massive hemor-rhage was 11 cases, among whom, 7 patients were kept in a stable condition with interventional therapy;2＆amp;nbsp;patients were kept in a stable condition by having compression bandage on the wound and accelerating the blood transfusion;2 patients suffered the function failure of multiple organs and died;1 patient suffered from multiple visceral metastasis and bone metastasis and then died .Conclusion：To fully grasp the risk factors for patients with sacral tumor surgery will help to determine the situation after the surgery , preoperative positive prevention , postoperative effective prevention and treatment will reduce the surgery risks .