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目的探讨术前DSA对于指导肿瘤手术方案制定的价值,特别是术前动脉栓塞对于有效地减少术中出血,提高肿瘤的完整切除率,增加手术安全性的意义。方法回顾性分析74例不同部位肿瘤的DSA检查和动脉栓塞的方法和技术因素。采用Seldinger’s技术做肿瘤供血动脉的超选择插管,以明胶海绵,PVA微球和金属弹簧圈,对肿瘤进行栓塞,而减少术中出血。结果74例肿瘤病人术前接受DSA检查和术前动脉栓塞术。动脉栓塞术后2～5天接受外科手术。其中71例术中出血明显减少,68例肿瘤不同程度缩小,63例肿瘤得以完整切除。结论肿瘤手术前DSA有助于更好地了解肿瘤自身及其周边的血管分布和供血情况,有利于指导手术。术前动脉栓塞可明显使肿瘤切除术出血更少,更安全,肿瘤完整切除率更高,手术时间缩短。
Objective To explore the value of preoperative DSA in guiding the development of surgical approaches to tumors, especially the value of preoperative arterial embolization in reducing the intraoperative bleeding, improving the complete resection rate and increasing the operative safety. Methods Retrospective analysis of 74 cases of different parts of the tumor DSA examination and arterial embolization methods and technical factors. Adopting Seldinger’s technique to make superselective intubation of tumor feeding artery, embolization of tumor with gelatin sponge, PVA microsphere and metal coil, and reduce intraoperative bleeding. Results 74 cases of tumor patients underwent preoperative DSA and preoperative arterial embolization. Arterial embolization 2 to 5 days after surgery. Among them, 71 cases of intraoperative bleeding were significantly reduced, 68 cases of tumor shrink to varying degrees, 63 cases of complete resection of the tumor. Conclusions DSA before tumor surgery can help to better understand the blood vessel distribution and blood supply in tumor itself and its surroundings, which is helpful for guiding the operation. Preoperative arterial embolization can significantly reduce the tumor resection bleeding, safer, more complete tumor resection rate, shorter operative time.