腹主动脉球囊阻断技术在骶骨肿瘤手术治疗中的应用

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

目的探讨腹主动脉球囊阻断技术控制骶骨肿瘤手术中出血的安全性和有效性。资料与方法选取2009年1月—2013年12月收治的骶骨肿瘤病人31例,其中16例行传统骨科切除术（常规手术组）,15例于骨科术中行腹主动脉球囊阻断（球囊阻断组）。记录术中球囊阻断时间、术中出血量、术中输血量及手术时间,观察手术效果及并发症。采用两独立样本t检验比较两组病人的术中出血量、术中输血量及手术时间。结果球囊阻断组均成功置入球囊,操作时间20-30 min,阻断时间30--45 min,平均（32±7）min。球囊阻断组术中出血量、术中输血量及手术时间均明显少于常规手术组（均P〈0.05）。两组病人均未发生下肢静脉血栓形成、肢体远端缺血性坏死和肾功能衰竭等并发症。结论腹主动脉球囊阻断技术操作安全简便,能够有效地减少骶骨肿瘤术中出血。

Objective To evaluate the effect and safety of temporary balloon occlusion of abdominal aorta to control blood loss during sacral tumors surgery. Materials and Methods From January 2009 to December 2013, 31 patients with sacral tumors were recruited for this study. Totally 16 patients received the traditional surgery resection （control group） and the other 15 received temporary balloon occlusion of abdominal aorta during surgery （balloon occlusion group）. Intraoperative balloon occlusion time, blood loss, blood transfusion, and surgery time were recorded. Operation effect and complications were observed. Two independent sample t test was used to compare the blood loss, intraoperative blood transfusion and surgery time between the two groups. Results Every case needed about 20~30minutes for successful placement of the balloon catheter before the surgical operation. The balloon was inflated for blood flow occlusion from 30 minutes to 45 minutes （mean 32 ±7 minutes） accumulatively, the blood loss, blood transfusion, and surgery time in balloon occlusion group were significantly less than control group（P＆lt;0.05）. All the tumors of 31 cases had no lower limb venous thrombus or ischemic necrosis or failure of renal function happened. Conclusion The temporary balloon occlusion technique is safe and simple, which can effectively control the introperative hemorrhage.