目的

探讨脊柱肿瘤术前栓塞的临床应用价值。

方法

选取108例脊柱肿瘤患者，其中颈椎18例，胸椎41例，腰椎38例，骶椎11例。造影后选择性栓塞肿瘤供养动脉，共行术前栓塞患者97例，另选取11例为未经栓塞的患者及同期进行手术的患者共63例作为对照。栓塞物质为直径1 mm的明胶颗粒、PVA颗粒或钢圈。手术时机为栓塞后1～7 d。手术后两组术中估计出血量（estimated blood loss，EBL）的差异，采用t检验。

结果

行术前栓塞的患者共97例，栓塞血管134支，其中颈升动脉2支，甲状颈干1支，椎动脉1支，肋间动脉54支，腰动脉43支，髂内动脉28支，骶正中动脉5支。栓塞后手术的91例患者术中EBL为300～3000 ml，平均1240 ml；同期63例未行术前栓塞的脊柱肿瘤，术中EBL为1400～6000 ml，平均2360 ml，两组差异有统计学意义（P＜0.01）。91例行术前栓塞的患者均无并发症。

结论

脊柱肿瘤术前栓塞能显著减少术中出血，可使肿瘤有更多获得完全切除的机会。

Objective

To discuss the clinical value of preoperative embolization of vertebral tumors.

Methods

Data of 108 patients were retrospectively studied.Eighteen lesions were in the cervical，41 in the thoracic，38 in the lumber and 11 in the sacral regions.The vertebral tumors were embolized prior to operation with gelatin sponge particles.The 97 cases of preoperative embolization patients were select.Polyvinyl alcohol（PVA）particles or coils.Surgical operations were performed within 1—7 days after the embolization.The difference of estimated blood loss（EBL）between two groups were analysed.

Results

Totally 134 vessels of 97 patients were embolized，which included ascending cervical artery，2；thyrocervical trunk，1；vertebral artery，1；intercostal artery，54；lumber artery，43；internal iliac artery，28 and median sacral artery，5.Intraoperative hemorrhage showed a mean value of 1240 ml with range of 300-3000 ml in patients after embolization，and a mean value of 2360 ml with range of 1400—6000 ml in patients without embolization at the same period（P＜0.05）.None of the patients developed postembolization complications.

Conclusions

Embolization prior to operation can reduce intraoperative blood loss significantly and conduce the total resection.