腹主动脉球囊低位临时阻断血流在高位骶骨肿瘤手术中的相关应用

The Application of Temporary Balloon Occlusion of the Abdominal Aorta in High-order Position Sacral Tumor Surgical Operation

目的探讨腹主动脉球囊低位临时阻断血流技术在高位骶骨肿瘤中的应用.方法回顾分析昆明医科大学第三附属医院自2005年1月至2015年12月所收治的高位骶骨肿瘤患者79例,其中行腹主动脉球囊临时阻断血流骶骨肿瘤切除术的患者50例,其中男性29例,女性21例,非腹主动脉球囊临时阻断血流骶骨肿瘤切除术的患者29例,其中男性18例,女性11例,通过对手术时间、术中出血量、术后深静脉血栓发生情况、术后拔管时间进行统计学分析.结果球囊组手术时间(146.36±29.38)min,非球囊组手术时间(206.03±125.93)min,球囊组出血量(1610.70±491.14)m L,非球囊组出血量(2 658.62±562.213)m L,球囊组拔管时间(6.60±2.76)d,非球囊组拔管时间(12.52±2.86)d,差异均有统计学意义(P<0.01).2组术后深静脉血栓的发生差异无统计学意义(P>0.05).结论在高位骶骨肿瘤的切除术中,采用腹主动脉球囊低位临时阻断血流技术,可以减少术中出血,良好显露肿瘤边界,便于术中创面的止血,缩短手术时间,减少术后渗出,基本不增加术后深静脉血栓的发生率.在高位骶骨肿瘤的切除中,值得临床推广应用.

Objective To evaluate temporary balloon occlusion of the abdominal aorta in high-order position sacral tumor surgical operation as a useful adjuvant technique.Methods Reviewed 79 cases of patients from 2005 to 2015 treated in our department and the diagnosis of high-order position sacral tumor. Temporary balloon occlusion of abdominal aorta was used in 50 patients（male 29, female 21） during the sacral tumors surgical operations. The other 29 patients（male 18, female 11） with sacral tumors who received the non-temporary balloon occlusion therapy were used as control group. The statistical differences of the whole surgery time, the blood loss during the surgery, the happening of the postoperative deep vein thrombosis, the time of the postoperative extubation were analyzed. Results The differences were statistically significant（P〈0.001） in the whole surgery time of balloon occlusion group（146.36±29.38） min vs non-balloon occlusion group（206.03±125.93） min,the blood loss of balloon occlusion group（1610.70±491.14） ml vs non-balloon occlusion group（2658.62±562.213） mL,and the time of the postoperative extubation of balloon occlusion group（6.60±2.76） d vs non-balloon occlusion group（12.52±2.86） d. However, there was not significant difference of the happening of the postoperative deep vein thrombosis between balloon occlusion group and non-balloon occlusion group. Conclusion Temporary balloon occlusion of abdominal aorta is effective and reliable. It significantly reduced the time of operations, the loss of blood, mean days in hospital, effusion of post-operation and recurrence rate. It makes the operation of sacral tumors much more safer than before and is a technique worthy of popularizing.