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目的探讨介入性动脉栓塞对于骨肿瘤手术的作用和意义,特别是对于有效地减少术中出血的意义。方法回顾性分析27例不同部位肿瘤的动脉栓塞的方法和技术因素。采用Seldinger’s技术超选择插管,以明胶海绵、PVA微球和金属弹簧圈对肿瘤进行栓塞。结果 27例骨肿瘤患者术前接受DSA检查和术前动脉栓塞术。动脉栓塞术后1～5d接受外科手术。其中22例术中出血明显减少,23例肿瘤不同程度缩小,20例肿瘤得以完整切除。结论手术前DSA有助于更好地了解骨肿瘤自身及其周边的血管分布和供血情况,有利于指导手术。术前动脉栓塞可明显减少术中出血,更安全,肿瘤完整切除率更高,手术时间缩短。
Objective To investigate the effect and significance of interventional arterial embolization on bone tumor surgery, especially for the purpose of reducing intraoperative bleeding effectively. Methods Retrospective analysis of 27 cases of different parts of the tumor artery embolization methods and technical factors. Seldinger’s technique was used to superselective intubation and the tumor was embolized with gelatin sponge, PVA microspheres and metal coils. Results Twenty-seven patients with bone tumor underwent preoperative DSA and preoperative arterial embolization. Arterial embolization 1 ~ 5d after surgery. Twenty-two of them had a significant reduction in intraoperative bleeding, 23 had a decrease in varying degrees, and 20 had complete resection. Conclusions DSA before surgery can help to better understand the blood vessel distribution and blood supply of the bone tumor itself and its surroundings, which is helpful for guiding the operation. Preoperative arterial embolization can significantly reduce intraoperative bleeding, safer, more complete tumor resection rate, shorter operative time.