腹主动脉内球囊阻断技术用于骨盆和骶骨肿瘤切除术的研究进展

Research progress of abdominal aortic balloon occlusion in the pelvic and sacral tumor resection

骨盆环肿瘤是严重危害人类健康的肿瘤,手术切除为主要治疗手段,但由于该部位解剖复杂,毗邻重要的血管、神经和内脏器官,且肿瘤发病相对隐匿,早期症状不明显,患者就诊时通常肿瘤体积巨大,需要外科医师和麻醉科医师及护理团队等多学科合作。术中大量出血为肿瘤切除术的主要并发症之一,严重时会引起失血性休克、凝血功能障碍,甚至危及生命,同时还会导致手术野不清,影响手术进程。腹主动脉内球囊临时阻断的应用可明显减少术中出血,改善了患者预后,减轻疾病负担。为了更好地配合手术团队,同时促进腹主动脉内球囊阻断技术的临床推广和应用,麻醉科医师需准确掌握骨盆和骶骨肿瘤切除术的术前评估及准备、应用球囊引起的术中特殊病理生理改变、处理原则及术中术后管理要点。

The pelvic ring tumor is considered to be a serious disease that poses a significant threat to human health.However,due to the complex anatomy of this site,which is adjacent to important blood vessels,nerves and internal organs,and the signs and symptoms of early tumor are usually mild and not symptomatic,and the incidence of the tumors is relatively hidden,tumors are found large in size and rich in blood supply,which the cooperation of a multidisciplinary team such as surgeons anesthesiologists and nursing team is required.Massive intraoperative bleeding,which is one of the main complications of sacral tumor resection,in severe cases will cause hemorrhagic shock,coagulation dysfunction,even life-threatening,meanwhile it will also lead to unclear surgical field,affect the process of surgery.Inspired by the successful use of intra-aortic balloon occlusion,it has been gradually applied to control the surgical bleeding of the torso both at home and abroad.Abdominal aortic balloon temporary blocking application greatly reduces the intraoperative bleeding,shortens the operation time,increases the safety of perioperative,improved the prognosis of patients,reduces the burden of disease.To better cooperate with the surgical team,also to promote the clinical promotion and application of abdominal aortic balloon,anesthesiologists should master the preoperative assessment and preparation for pelvic and sacral tumor resection,the specific pathophysiological changes caused by balloons,management principles,and intraoperative and postoperative management points.