论文部分内容阅读
目的探讨靶血管栓塞后手术治疗复发性骶骨脊索瘤的临床疗效。方法对1993～2008年间36例骶骨脊索瘤患者进行回顾性分析,将27例初发患者列为初发组,外院初次手术后复发来我院9例列为复发组。所有患者均采用靶血管栓塞后行后路手术。统计学分析两组病例术中出血量、输血量、术后引流量、伤口并发症、术后二便功能和复发情况。结果两组患者平均出血量、平均输血量、术后引流量差异无统计学意义,P>0.05。平均随访68个月,复发组术后大小便功能障碍较初发组多(P<0.05)。初发组复发10例,复发组再次复发7例,差异有统计学意义(P<0.05)。结论选择性靶血管栓塞可有效地减少术中出血,对于复发性骶骨脊索瘤仍是安全有效的方法。复发性骶骨脊索瘤术后大小便功能恢复较初发患者差,并且较初发患者更易复发。
Objective To investigate the clinical effect of surgical treatment of recurrent sacral chordoma after target vessel embolization. Methods Thirty-six patients with sacral chordoma from 1993 to 2008 were retrospectively analyzed. Twenty-seven patients with primary chordoma were recruited as initial group, and nine patients with recurrent group were recruited as recurrence group after initial operation. All patients were treated with target vessel embolization and posterior surgery. Statistical analysis of two groups of cases of intraoperative blood loss, blood transfusion, postoperative drainage volume, wound complications, postoperative bowel function and recurrence. Results The mean blood loss, average blood transfusion and postoperative drainage volume of two groups had no significant difference (P> 0.05). After an average follow-up of 68 months, the postoperative urinary and urinary dysfunction in the recurrent group was more than that in the primary group (P <0.05). There were 10 cases relapsed in the initial group and 7 cases relapsed in the recurrence group, the difference was statistically significant (P <0.05). Conclusion Selective target vessel embolization can effectively reduce intraoperative bleeding and is still safe and effective for recurrent sacral chordoma. Recurrent sacral chordoma surgery postoperative urinary recovery than patients with initial poor, and more easily relapsed than the initial patients.