摘要
目的 探讨高位骶骨肿瘤切除和重建方式。 方法 我院于 1998年 10月至 2 0 0 2年 4月 ,收治 35例原发性高位骶骨肿瘤患者 ,L5 S14例 ,L5 S2 2例 ,S14例 ,S1 2 8例 ,S1 3 6例 ,S1 46例 ,S1 55例 ;肿瘤切除方式 :L5 S1椎节切除 4例 ,L5 S2 椎节切除 2例 ,全骶骨切除 9例 ,骶骨部分切除 2 0例。肿瘤切除术后给予腰椎与骨盆TSRH或ISOLA内固定术 ,并给予相应的放疗与化疗。 结果术后随访 6～ 4 2个月 ,1例术后出现排尿困难 ,2例术后出现脑脊液瘘 ,1例术后切口感染及延期愈合 ,1例尾端切口皮肤坏死 ,术后近期疗效均较满意 ,患者腰骶部疼痛及神经功能有不同程度改善 ,1例脊索瘤和 2例恶性纤维组织细胞瘤患者于术后 1年复发 ,其中 1例恶性纤维组织细胞瘤患者于术后 19个月因肺部转移全身衰竭死亡 ,所有患者均未发生断钉、断棒。 结论 肿瘤的切除方式和术后综合治疗对预后具有重要的影响 ,骶骨切除术后腰椎与骨盆内固定术有利于保持腰椎及骨盆的稳定性 ,更好地减轻疼痛 。
Objective To investigate the way of resection of high sacrum tumors and the way and duration of the spinal pelvic TSRH or ISOLA internal fixation. Method From October 1998 through April 2002, 35 patients with sacral tumor were enrolled in our hospital, inclnding 4 cases in L 5 S 1, 2 in L 5 S 2, 4 in S 1, 8 in S 1 2 , 6 in S 1 3 , 6 in S 1 4 , 5 in S 1 5 . 35 patients were followed by lumbo pevic TSRH or ISOLA internal fixation and corresponding chemotherapy and radiotherapy. Results In the follow up period of 6～42 months, the short term results were satisfactory with the lumbosacral pain reduced and the neurological function improved in different degrees, however dysuria occurred in 1 case and skin necrobiosis at coccygeal incision occurred in 1 case; two cases experienced cerebrospinal fluid leakage and 1 case experienced postoperative infection and delayed healing, 1 case with chodoma and 2 cases with malignant fibrous histocytoma recurred 1 year after postoperation, one of these 2 cases with malignant fibrous histocytoma suffered from lung metastasis and died of system failure 19 months after postoperation. No fractured rod occurred. Conclusion Surgical procedure and postoperative coprenhensive treatment have important effects on the prognosis. High sacral tumor resection and reconstruction are effective means of achieving stabilization, providing significant pain relief and preserving ambulatory capacity.
出处
《中华外科杂志》
CAS
CSCD
北大核心
2003年第8期575-577,共3页
Chinese Journal of Surgery
