[目的]探讨术前髂内动脉栓塞术联合切刮术治疗骶骨巨细胞瘤(giant cell tumor,GCT)的临床疗效。[方法]回顾性研究了本院2006年7月~2012年6月收治的16例骶骨巨细胞瘤患者临床资料,所有患者均为初诊病人,其中男7例,女9例,平均年龄31.6岁(17~48岁),GCT位于S1者1例,S1、2者2例,S1~3者7例,S1~4者2例,S2、3者2例,S2~4者2例。所有患者均于手术前1 d行髂内动脉栓塞术,术中低位肿瘤部分切除、高位肿瘤局部刮除术。根据MSTS93(Musculoskeletal Tumor Society)保肢术后功能评价标准对患者术前及最近一次随访时功能情况进行评价。[结果]16例病人均获得随访,平均随访时间33.5个月(12~84个月),期间无患者死亡及肿瘤肺部转移。患者术中平均失血量3 450 ml(1 600~4 250 ml),6例(37.5%)出现肿瘤局部复发,3例(18.7%)出现不同程度神经根损伤症状,4例(25%)出现切口并发症。2例(12.5%)出现脑脊液漏。术前患者MSTS93总体平均评分为15.4分(4~21分),术后最后一次随访时患者MSTS93总体平均评分为26.3分(16~30分),术前、术后评分比较差异具有统计学意义(P=0.000<0.05)。最后一次随访时患者肢体功能总的优良率为87.6%。[结论]对骶骨GCT患者应根据肿瘤累及的区域选择不同的治疗方式,术前髂内动脉栓塞联合切刮术是治疗骶骨巨细胞瘤的一种有效方法,尽量保留双侧S1、2及至少单侧S3神经根加上骨盆重建术能获得良好的功能恢复。 [Objective] To investigate the clinical efficacy of preoperative internal iliac artery embolization combined with cut-off in the treatment of giant cell tumor (GCT). [Methods] The clinical data of 16 patients with giant cell tumor of the sacrum admitted to our hospital from July 2006 to June 2012 were retrospectively studied. All patients were newly diagnosed, including 7 males and 9 females, with an average age of 31.6 years (17 to 48 years old). There were 1 case with GCT in S1, 2 cases with S1 and 2, 7 cases with S1 ~ 3, 2 cases with S1 ~ 4, 2 cases with S2 and 3 cases and 2 cases with S2 ~ 4. All patients underwent internal iliac artery embolization 1 d before operation, partial resection of low and advanced tumors, and local high-grade tumor curettage. According to MSTS93 (Musculoskeletal Tumor Society) after limb salvage function evaluation criteria of patients before and at the last follow-up evaluation of functional status. [Results] All the 16 patients were followed up for a mean of 33.5 months (range, 12-84 months). No patient died and tumor lung metastasis occurred during the follow-up period. The mean intraoperative blood loss was 3 450 ml (1 600 ~ 4 250 ml), 6 cases (37.5%) had local tumor recurrence, 3 cases (18.7%) showed different degrees of nerve root injury symptoms and 4 cases (25%) appeared Incision complications. Cerebrospinal fluid leakage occurred in 2 patients (12.5%). The overall mean MSTS93 score was 15.4 (4-21) before surgery, and the overall average MSTS93 score was 26.3 (16-30) at the last postoperative follow-up. The preoperative and postoperative scores were significantly different (P = 0.000 <0.05). At the last follow-up, the overall excellent and good rate of limb function was 87.6%. [Conclusions] Different methods of treatment should be chosen according to the tumor involved area in patients with sacral GCT. Preoperative internal iliac artery embolization combined with scraping is an effective method for the treatment of giant cell tumor of the sacrum, so as to keep bilateral S1,2 and at least Unilateral S3 nerve root plus pelvic reconstruction can achieve good functional recovery.