脊髓血管网织细胞瘤术出血危险因素分析

Analysis of risk factors for bleeding during spinal hemangioblastoma surgery

目的探讨脊髓血管网织细胞瘤术中出血相关的危险因素.方法回顾性分析2016年1月至2018年12月首都医科大学附属北京天坛医院神经外科69例脊髓血管网织细胞瘤患者的临床资料,分析术中出血量的危险因素.结果69例患者男性37例(53.6%),女性32例(46.4%),出血量50~1200 ml,平均(273±124)ml.以出血量300 ml为界限,将患者分为低危组(出血量<300 ml)58例与高危组(出血量≥300 ml)11例.多因素分析显示肿瘤部位(OR=1.400)、复发肿瘤(OR=1.350)、肿瘤粘连程度(OR=2.211)与切除程度(OR=2.052)与脊髓血管网织细胞瘤术出血量增多相关.结论对于肿瘤位于脊髓腹侧、复发、肿瘤严重粘连和手术次全切的脊髓血管网织细胞瘤,应该警惕术中出血量增多的可能,做好预防大出血的准备措施.

Objective To explore the risk factors for bleeding during spinal hemangioblastoma surgery.Methods A retrospective study was conducted among 69 spinal hemangioblastoma patients who underwent selective surgeries at Beijing Tiantan Hospital,Capital Medical University from January 2016 to December 2018.The risk factors for blood loss of spinal hemangioblastoma surgery were analyzed.Results There were 37 male(53.6%)and 32 female(46.4%)patients.The amount of bleeding was 50-1200 ml,with an average(273±124)ml.The operation was divided into low-risk group(bleeding volume<300 ml)58 cases and high-risk group(bleeding volume≥300 ml)11 cases.Multivariate analysis showed that tumor location(OR=1.400),recurrence(OR=1.350),severe adhesion(OR=2.211)and resection degree(OR=2.052)were related to the increase of bleeding volume in spinal angioreticuloma surgery.Conclusions For the hemangioblastoma of the spinal cord,which is located in the ventral side of the spinal cord,recurrences,severe adhesion of the tumor,and subtotal resection of the tumor,we should be alert to the possibility of increased bleeding during the operation,and make preparations to prevent massive bleeding.