介入栓塞在脊柱肿瘤外科手术中的应用

The clinical application of interventional embolization in surgical treatment of spinal tumors

目的探讨术前选择性介入栓塞在减少脊柱肿瘤外科手术中出血的效果和提高手术疗效的应用。方法回顾性分析83例脊柱肿瘤患者临床资料,其中26例患者外科手术前对肿瘤血管选择性介入栓塞(栓塞组),57例患者术前未行介入栓塞(对照组),比较两组手术创伤、术后恢复及术后并发症。结果两组患者在手术创伤、术后恢复方面差异有统计学意义(P<0.05),介入组术后出血并发症率显著低于对照组(0和5.8%,P<0.05)。结论对于脊柱肿瘤特别是富血供肿瘤术前选择性栓塞肿瘤血管能有效减少外科手术中出血、缩短手术时间、减少术后出血,有利于患者术后早期恢复,是一项有临床实用价值的微创技术。

Objective To evaluate preoperative selective interventional embolization in reducing surgical bleeding of spinal tumors and in improving therapeutic effect. Methods During the period from January 2009 to June 2013, a total of 83 patients with spinal tumors were admitted to Fujian Provincial Hospital to receive surgery. The clinical data were retrospectively analyzed. Among the 83 patients,preoperative selective interventional embolization was carried out in 26（embolization group） and no preoperative selective interventional embolization was used in 57（control group）. The surgical trauma,postoperative recovery and postoperative complications were recorded, and the results were compared between the two groups. Results Statistically significant differences in the surgical trauma and postoperative recovery existed between the two groups（P〈0.05）. The incidence of postoperative bleeding complication in the embolization group was significantly lower than that in the control group（0 vs 5.8%, P〈0.05）. Conclusion For spinal tumors, especially for hypervascular spinal tumors, preoperative selective interventional embolization treatment can effectively reduce the blood loss during the operation, shorten the operation time and reduce postoperative bleeding complications, which are definitely favourable for the early recovery of the patient. Therefore, this minimally invasive technique is of high value in clinical practice.