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[目的]探讨脊柱转移瘤术中出血量多少与原发肿瘤组织来源类型的相关性。[方法]回顾性分析2000年1月~2013年5月手术切除并经病理证实为脊柱转移瘤的标本156例,均经石蜡包埋处理且免疫组化确认肿瘤组织来源。手术方式为胸椎或腰椎后入路全脊椎切除重建术。出血量统计均由手术者、麻醉师及巡回护士三方判断并准确记录,分低出血量组:出血量<1 000 ml;中出血量组:1 000 ml≤出血量<2 000 ml;高出血量组:出血量≥2 000ml。[结果]低出血量组80例,病理类型为:前列腺癌13例,乳腺癌19例,肺鳞癌28例,甲状腺癌16例,食管癌2例,膀胱癌1例,原发灶不明1例;中出血量组60例,病理类型为:胰腺癌2例,小细胞肺癌9例,肺腺癌25例,肝细胞癌24例;高出血量组:16例,病理类型为:肝细胞癌13例,肾癌2例,原发灶不明1例。采用SPSS 19.0统计软件分析各组间出血量有显著性差异,P=0.000。[结论]脊柱转移瘤出血量的多少与原发肿瘤的组织类型有直接相关性,来源于肝细胞癌、肺腺癌、小细胞肺癌、胰腺癌、肾癌等的脊柱转移瘤出血量较大,来源于前列腺癌、乳腺癌、肺鳞癌、甲状腺癌等的转移瘤出血量相对较少。
[Objective] To investigate the correlation between the amount of bleeding during spinal metastases and the type of primary tumor. [Method] A total of 156 specimens of spondylolisthesis surgically removed from January 2000 to May 2013 were retrospectively analyzed. Both of them were paraffin-embedded and immunohistochemically confirmed the source of tumor tissue. Surgical procedures for the thoracic or lumbar posterior approach total spondylotomy reconstruction. Bleeding statistics were determined by the surgeon, anesthetist and tour nurse tripartite judgment and accurate records, sub-low bleeding group: bleeding <1 000 ml; the amount of bleeding in: 1 000 ml ≤ bleeding <2 000 ml; high bleeding Quantity group: bleeding ≥ 2000ml. [Results] The low bleeding group of 80 cases, pathological types: 13 cases of prostate cancer, 19 cases of breast cancer, squamous cell carcinoma of the lung in 28 cases, 16 cases of thyroid cancer, esophageal cancer in 2 cases, 1 case of bladder cancer, primary tumor unknown 1 Cases; the amount of bleeding in the group of 60 cases, pathological types: 2 cases of pancreatic cancer, small cell lung cancer in 9 cases, 25 cases of lung adenocarcinoma, hepatocellular carcinoma in 24 cases; high bleeding group: 16 cases, pathological types: 13 cases of cancer, 2 cases of renal cell carcinoma, 1 case of unknown primary tumor. The statistical analysis of SPSS 19.0 software showed significant differences in bleeding between groups, P = 0.000. [Conclusion] There is a direct correlation between the amount of hemorrhage in spinal metastases and the type of primary tumor. The amount of bleeding in metastatic spinal tumors from hepatocellular carcinoma, lung adenocarcinoma, small cell lung cancer, pancreatic cancer, kidney cancer is larger , Derived from prostate cancer, breast cancer, lung squamous cell carcinoma, thyroid cancer and other metastases relatively small amount of bleeding.