骨盆肿瘤多支血供的DSA诊断和治疗及其临床意义

Pelvic tumors with multi-branch blood supplying: diagnosis and treatment by digital subtraction angiography and its clinical significance

目的 :分析骨盆肿瘤数字减影血管造影 (DSA)表现 ,探讨骨盆肿瘤多支血供的诊断和治疗及其临床意义。方法 :术前栓塞治疗 4 8例骨盆肿瘤患者 ,观察其临床改善情况 ,计算术中失血量和手术时间。结果 :血管造影可清楚显示肿瘤的大小及多支血供特点 ,术中失血量 (2 177 1± 96 9 8)ml,手术时间 (198 9± 97 4 )min。术前栓塞可减少术中失血量 ,并能缩短手术时间。肿瘤供血血管共 90支 ,栓塞 81支 ,栓塞率 90 %。组织学证实 :肿瘤均有不同程度的坏死、液化和囊性变 ,部分肿瘤有假包膜形成。结论 :骨盆肿瘤术前栓塞时应考虑到多支血供的可能 ,力争栓塞肿瘤全部供血血管 ,以提高疗效。术前栓塞是骨盆肿瘤手术前有效的辅助治疗手段。手术时机应选择在栓塞后 6d内。

Objective: To analysis the manifestation of pelvic tumors by digital subtraction angiography (DSA) and to explore the diagnosis and treatment of pelvic tumors with multi branch blood supplying and its clinical significance. Methods: Forty eight patients with pelvic tumors were embolized preoperatively and their clinical improvement was observed after the embolization. The blood loss and the time spent during operation were counted. Results: DSA could clearly show the size and features of multi branch blood supply of the tumors. The blood loss during the operation was 2177.1±969.8 ml and the time spent during the operations was 198.9±97.4 minutes. The preoperative embolization could reduce blood loss and shorten the time of operation. There were 90 branches of blood supplying altogether, and 81 of them were embolized. The rate of embolization was 90%. The histological results confirmed that necrosis, liquefaction, cystic degeneration and the formation of pseudocapsule in all tumors occurred, despite of their varying degrees. Conclusion: The possibility of the multi branch blood supply to pelvic tumors should be considered when the preoperative embolization was performed. All the vessels that supply to the tumors should be embolized in order to improve the efficacy of treatment. The preoperative embolization is an effective adjuvant therapy before pelvic tumor operations. The opportunity of surgery should be chosen within 6 days after embolization of pelvic tumors.