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目的术中应用球囊导管阻断肿瘤近端大动脉后再切除骨肿瘤,探讨其对减少术中肿瘤出血的临床意义。方法2003年3月至2005年3月,对4例高位骶骨肿瘤(骨巨细胞瘤3例、脊索瘤1例)和4例髋区骨转移瘤(肺癌3例、骨肉瘤1例)患者施行肿瘤切除术。术中先用球囊导管阻断下腹主动脉或一侧髂总动脉,每次阻断动脉40～70min或间隔15～20min再阻断,后行肿瘤切除。结果阻断大动脉后,在分块切除及刮除骶骨肿瘤和边缘性切除股骨近端骨转移瘤时,出血极少,无须止血,有类似肢体手术中应用止血带的效果,全部病例在切除肿瘤过程中出血100～300ml。术野干净,解剖清晰,肿瘤边界易确定,肿瘤切除完全,肿瘤的术野污染小。手术全过程中,患者血压均平稳。结论应用球囊导管阻断肿瘤近端大动脉,再切除高位骶骨肿瘤和髋区肿瘤,可有效地减少术中出血,提高手术的安全性。
Objective To observe the clinical significance of balloon catheter ablation to reduce the intraoperative tumor hemorrhage after balloon catheter ablation of the proximal aorta of the tumor. Methods From March 2003 to March 2005, 4 patients with high sacral tumor (3 cases of giant cell tumor of bone, 1 case of chordoma) and 4 cases of bone metastases of the hip region (3 cases of lung cancer and 1 case of osteosarcoma) Tumor resection. Intraoperative balloon catheter blocking the lower abdominal aorta or common iliac artery, each blocking the artery 40 ~ 70min or interval 15 ~ 20min and then blocked, the tumor resection. Results After occlusion of the aorta, hemorrhage was minimal and no hemostasis was required during resection and dissection of the sacrum tumor and marginal resection of the proximal femoral bone metastases. In all cases, the resection of the tumor The process of bleeding 100 ~ 300ml. The surgical field is clean, the anatomy is clear, the border of the tumor is easy to be determined, the tumor resection is complete and the tumor field has little pollution. The whole process of surgery, patients with blood pressure are stable. Conclusion The application of balloon catheter to block the proximal aorta of the tumor and resection of high sacral tumors and hip tumors can effectively reduce intraoperative bleeding and improve the safety of the operation.