摘要
目的探讨低位腹主动脉内球囊长时间阻断血流技术在骨盆及骶骨肿瘤外科治疗中的应用价值。方法纳入2005年1月至2013年6月四川大学华西医院骨科收治的行腹主动脉内球囊阻断的骨盆或骶骨肿瘤患者。根据球囊的阻断时限,将患者分为A（〈90 min）、B（90-180 min）、C（〉180 min）三组。比较三组患者术中出血量、输血量、术后引流量、平均住院时间,以及术后并发症的差异。结果共纳入78例患者,其中A组21例,B组38例,C组19例。所有患者均获得整块切除,术中均未发生球囊移位及腹主动脉血流渗漏现象。三组间比较,其术中出血量（P=0.026）和平均住院日（P=0.021）的差异有统计学意义,进一步的两两比较结果显示,C组均明显大于A、B两组（P均〈0.05）。而在输血量、术后引流量和术后并发症发生率方面,三组间差异均无统计学意义（P均〉0.05）。结论在骨盆及骶骨肿瘤外科治疗中,选择性延长腹主动脉内球囊阻断时间可充分暴露手术野、减少术中出血,从而节约血液成本、提高手术安全性,且不增加术后远端肢体麻痹、甚至缺血坏死等并发症的发生率。
Objective To explore the value of the long time lower abdominal aorta balloon block technology in the pelvis or sacrum tumor surgery. Methods From January 2005 to June 2013, the sacrum or pelvic tumor patients underwent the long time lower abdominal aorta balloon block technology in the Orthopedics Department of West China Hospital of Sichuan University were enrolled. According to the balloon blocking time, patients were divided into A（〈90mins）, B（90 to 180 mins）, and C（〉180 mins） groups. The intraoperative blood loss, blood transfusion amount, average lengths of hospital stay, postoperative volume of drainage, and postoperative complications were compared among the three groups. Results A total of 78 patients were included, of which 21 were in group A, 38 were in group B and 19 were in group C. All patients received en bloc resection, and did not experience intraoperative balloon shift and abdominal aorta flow leakage. Comparing the three groups, there were significant differences in intraoperative blood loss（P=0.026）and average lengths of hospital stay（P=0.021）. Further pairwise comparison showed the intraoperative blood loss and average lengths of hospital stay in group C were significantly higher than those in group A and group B. In addition, there were no statistical differences among the three groups in blood transfusion amount, postoperative volume of drainage and postoperative complications. Conclusion In the pelvis and sacrum tumor surgery, extending the time of abdominal aorta balloon block can reduce bleeding, save blood, increase the safety of surgery without increasing in postoperative complications.
出处
《中国循证医学杂志》
CSCD
2015年第8期878-882,共5页
Chinese Journal of Evidence-based Medicine
基金
四川省科技厅支撑计划(编号:2010FZ0088)
关键词
骶骨肿瘤
骨盆肿瘤
球囊阻断
腹主动脉
并发症
安全性
Sacrum tumor
Pelvic tumor
Balloon occlusion
Abdominal aorta
Complication
Safety
