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目的探讨选择性动脉栓塞后肿瘤椎体切除重建的疗效及价值。资料与方法选择有脊髓压迫症状的胸腰椎肿瘤患者24例,分成对照组(n=11)和研究组(n=13)。对照组直接行肿瘤椎体切除人工椎体置换椎体重建术;研究组先行肿瘤供血动脉栓塞化疗后,再行肿瘤椎体重建术。结果对照组4例手术失败,7例手术成功,成功率57%,术中平均出血量为3385ml、平均手术时间5h;研究组13例肿瘤椎体全部手术切除成功,成功率达100%,术中平均出血量为842ml,平均手术时间3h。研究组与对照组比较术中平均出血量、手术时间差异有统计学意义(P<0.01)。所有患者随访6～36个月神经功能恢复满意,椎体重建稳定性良好。结论术前胸腰椎动脉栓塞便于肿瘤椎体切除及重建,可提高患者的生存质量。
Objective To investigate the curative effect and value of tumor resection and reconstruction after selective arterial embolization. Materials and Methods Twenty-four patients with thoracolumbar tumors with spinal cord compression were selected and divided into control group (n = 11) and study group (n = 13). The control group was treated with vertebroplasty and artificial vertebral body replacement. The study group received tumor embolization and chemotherapy followed by tumor vertebral body reconstruction. Results In the control group, 4 cases failed surgery, 7 cases achieved successful operation, the success rate was 57%, mean intraoperative blood loss was 3385ml and average operation time was 5 hours. All 13 cases of tumor in operation group were successfully resected, with a success rate of 100% The average amount of bleeding in 842ml, the average operation time 3h. The mean intraoperative blood loss and operation time in the study group and the control group were statistically significant (P <0.01). All patients were followed up for 6 to 36 months, satisfactory neurological recovery, vertebral reconstruction of good stability. Conclusions Preoperative thoracic and lumbar artery embolization facilitates tumor resection and reconstruction, which can improve the quality of life of patients.