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目的 :通过对骨盆肿瘤术前栓塞的分析 ,探讨其在外科手术中减少出血的意义及如何避免并发症。材料和方法 :本组16例进行了18次术前栓塞。病种包括 :转移瘤2例 ,脊索瘤4例 ,软骨肉瘤4例 ,骨肉瘤2例 ,尤文氏肉瘤1例 ,非何杰金氏淋巴瘤1例 ,滑膜肉瘤1例 ,平滑肌肉瘤1例。其中2例为术后复发 ,1例曾用原手术方法结扎左侧髂内动脉。栓塞物质全部使用钢丝圈及明胶海绵。结果 :本组18例次栓塞后造影均显示肿瘤血管、肿瘤染色明显减少 ,较栓塞前减少80%以上 ,全部病例均在栓塞后24小时内手术。术中出血量约在400～1200ml,平均720ml,较一般文献报道为低。原结扎髂内动脉可再通。术后复发与初次受栓塞者减少出血效果相近。所有病例无一例出现并发症。结论 :骨盆肿瘤术前栓塞是减少术中出血 ,提高手术成功率的有效且安全的方法。
OBJECTIVE: To analyze the significance of preoperative embolization in pelvic tumors to reduce bleeding during surgery and how to avoid complications. Materials and Methods: The group of 16 patients underwent 18 preoperative embolization. Diseases include: 2 cases of metastases, chordoma in 4 cases, chondrosarcoma in 4 cases, osteosarcoma in 2 cases, Ewing’s sarcoma in 1 case, non-Hodgkin’s lymphoma in 1 case, synovial sarcoma in 1 case, leiomyosarcoma in 1 case . Two of them were postoperative recurrence, and one had ligation of the left internal iliac artery with the original surgical method. Embolization material using all the traveler and gelatin sponge. Results: Twenty-eight patients underwent thrombolysis after angiography showed tumor vessels and tumor staining was significantly reduced, more than 80% less than before embolization, all cases were operated within 24 hours after embolization. Intraoperative blood loss of about 400 ~ 1200ml, an average of 720ml, lower than the average reported in the literature. The original internal iliac artery ligation can be recanalized. Postoperative recurrence and initial embolization were similar to reduce bleeding. No case of any complication occurred in all cases. Conclusion: Preoperative embolization of pelvic tumor is an effective and safe method to reduce intraoperative bleeding and improve the success rate of operation.