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目的探讨骶骨肿瘤手术并发症类型及围手术期的关键处理措施,从而改善预后。方法回顾性分析2004年1月至2008年1月进行手术切除的78例骶骨肿瘤患者,分析术后常见并发症的类型原因及其围手术期预防和处理措施。结果出血、神经损伤、复发转移及伤口问题是骶骨肿瘤术后最常见的并发症。本组病例中,术中出血>3000ml 11例(14.1%),神经损伤中括约肌功能障碍或性功能障碍18例(23.0%),肢体运动功能障碍3例(3.8%),肢体感觉功能障碍15例(19.0%),伤口相关并发症12例(15.4%),髂腰内固定相关并发症8例(10.0%),所有患者中位随访时间58个月(48-92个月),随访期间局部复发21例(26.0%),转移13例(16.7%),随访期间死亡16例。结论术中大量出血、神经损伤、伤口并发症及肿瘤复发转移是骶骨肿瘤术后常见并发症,如何降低并发症的发生是提高骶骨肿瘤疗效的关键。
Objective To investigate the types of sacral tumor surgical complications and the key measures during perioperative period so as to improve the prognosis. Methods A retrospective analysis of 78 patients with sacral tumors who underwent surgical resection from January 2004 to January 2008 was performed. The causes of common postoperative complications and their perioperative prevention and treatment measures were analyzed. Results Bleeding, nerve injury, recurrence, metastasis and wounds were the most common complication after sacral tumor surgery. In this group of patients, there were 11 cases (14.1%) of intraoperative bleeding> 3000ml, 18 cases (23.0%) of sphincter dysfunction or sexual dysfunction in nerve injury, 3 cases (3.8%) of limb motor dysfunction, limb sensory dysfunction 15 (19.0%), wound-related complications in 12 cases (15.4%), iliolumbastrophy-related complications in 8 cases (10.0%), and all patients were followed up for a median of 58 months (48-92 months) Local recurrence in 21 cases (26.0%), metastasis in 13 cases (16.7%), 16 patients died during follow-up. Conclusions A large number of intraoperative bleeding, nerve injury, wound complications and tumor recurrence and metastasis are common complications after sacral tumor. How to reduce the occurrence of complications is the key to improve the curative effect of sacral tumors.