腹主动脉血流阻断技术在行骨盆、骶骨肿瘤切除中的临床评价

Clinical evaluation of intraoperative block of abdomial aorta in sacral and pelvic tumors surgical operation

目的 :探讨应用腹主动脉血流临时阻断技术 (blockofabdomialaorta ,BAA)在行骨盆、骶骨肿瘤切除术中的临床价值。方法 :骨盆肿瘤切除术 1 64例 ,NBAA(非腹主动脉阻断 ) 94例 ,BAA(腹主动脉阻断 ) 70例 ;骶骨肿瘤切除术 1 0 9例 ,NBAA组 53例 ,BAA组 56例。结果 :骨盆肿瘤BAA组肿瘤大小比NBAA组平均大 0 .8cm ,术程平均缩短 2小时 ,术中平均减少出血 2 2 0 0ml ,手术并发症发生率平均减少 6 .3 % ,手术死亡率平均减少4 6 %。骶骨肿瘤BAA组肿瘤大小平均比NBAA组大 0 .7cm ,术程平均缩短 1小时 40分 ,术中平均减少出血 160 0ml ,手术并发症发生率平均减少 2 3 % ,手术死亡率平均减少 7.5 %。结论 :采用BAA技术 ,可以减少术中出血 ,缩短手术操作时间 ,使止血操作时间相对减少 ,手术切除肿瘤的时间相对延长 ,术野显露更加清楚 ,可以更彻底地切除肿瘤。同时降低了手术死亡率 ,减少并发症 。

Purpose:To evaluate intraoperative block of abdomial aorta(BAA) in surgery of sacral and pelvic tumors as a useful adjuvant technique.Methods:Of 164 cases of pelvic tumor who underwent resections and hemisections, the procedures in 94 cases were non block of abdominal aorta(NBAA);in 109 cases of sacral tumors various extents of acrectomy was done,53 cases had NBAA,56 cases had BAA.Results:In the pelvic tumor group, the size of tumors for BAA were on the average bigger than NBAA by 0.8 cm, the operation was shortened by 2 h, the dose of hemorrhage decreased by 2 200 ml. The complications of operation were reduced by 6.3%, death rate reduced by 4.6%. In the sacral tumor group, the size of tumors for BAA were on the average bigger than NBAA by 0.7 cm, the operation was shortened by 1 h and 40 min, the dose of hemorrhage decrease by 1 600 ml. The complications of operations were reduced by 23%, death rate reduced by 7.5%.Conclusions:The adoption of BAA adjuvant technique can reduce the intraoperative hemorrhage,the death rate, and the complications of operation, while also shortening the surgical operating time, and is a valuable clinical technique. [