症状性椎体血管瘤术前行选择性动脉栓塞的的临床价值
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摘要
目的探讨症状性椎体血管瘤(symptomatic vertebral hemangioma, SVH)外科手术前行选择性动脉栓塞(selective arterial embolization, SAE)的临床应用价值。方法收集我院2014年7月～2017年10月期间在外科手术前行介入栓塞治疗的SVH患者共22例,对血管造影及栓塞结果、栓塞并发症、外科手术术中出血量、外科手术时长、手术成功率进行回顾性分析。结果 22例患者术中造影结果均为阳性,阳性率100%;共发现靶血管67支,栓塞血管67支,栓塞成功率100%;栓塞后均未出现严重并发症;外科手术术中出血量350～2 400ml,平均1 100ml;手术平均时长130min;所有手术均成功完成,手术成功率100%。结论 SAE可有效的减少椎体血管瘤术中出血量,缩短手术时间,降低手术风险,提高手术成功率,是一种安全有效的术前干预治疗方式。
Objective To evaluate the clinical application value of selective artery embolism(SAE) in the treatment of symptomatic vertebral hemangioma(SVH) before surgical resection. Methods We collected and retrospectively analyzed the data of 22 patients, who were diagnosed with SVH and treated with SAE before surgery in our hospital from July 2014 to October 2017. The data included the result of angiography and embolization, embolization complications, bleeding amount of surgery, the surgical time and surgical success rate. Results Totally, all 67 vessels of 22 patients were embolized.The results of all arteriography were positive. Both the positive rate and embolization success rate were 100%. There were no serious complications after embolization. The blood loss ranged from 350～2 400 ml, with an average of 1 100 ml. The average operation time was 130 min. All the operations were successfully completed and the success rate was 100%. Conclusion The SAE before surgery can effectively reduce the blood loss of surgical resection, shorten the operation time, reduce the surgical risk, and improve the success rate of the operation, which is a safe and effective preoperative intervention treatment.
Objective To evaluate the clinical application value of selective artery embolism(SAE) in the treatment of symptomatic vertebral hemangioma(SVH) before surgical resection. Methods We collected and retrospectively analyzed the data of 22 patients, who were diagnosed with SVH and treated with SAE before surgery in our hospital from July 2014 to October 2017. The data included the result of angiography and embolization, embolization complications, bleeding amount of surgery, the surgical time and surgical success rate. Results Totally, all 67 vessels of 22 patients were embolized.The results of all arteriography were positive. Both the positive rate and embolization success rate were 100%. There were no serious complications after embolization. The blood loss ranged from 350～2 400 ml, with an average of 1 100 ml. The average operation time was 130 min. All the operations were successfully completed and the success rate was 100%. Conclusion The SAE before surgery can effectively reduce the blood loss of surgical resection, shorten the operation time, reduce the surgical risk, and improve the success rate of the operation, which is a safe and effective preoperative intervention treatment.
引文
[1] Doppman JL, Oldfield EH, Heiss JD. Symptomatic vertebral hemangiomas: treatment by means of direct intralesional injection of ethanol [J]. Radiology, 2000, 214(2): 341-348.
[2] Acosta FJ, et al. Comprehensive management of symptomatic and aggressive vertebral hemangiomas [J]. Neurosurg Clin N Am, 2008, 19(1): 17-29.
[3] Fox MW, Onofrio BM. The natural history and management of symptomatic and asymptomatic vertebral hemangiomas [J]. J Neurosurg, 1993, 78(1): 36-45.
[4] 杜建伟, 陆宁,王岩.脊柱血管瘤的诊断与治疗进展[J]. 实用临床医药杂志, 2016, 20(1): 186-189.
[5] Bas T, Aparisi F, Bas JL. Efficacy and safety of ethanol injections in 18 cases of vertebral hemangioma: a mean follow-up of 2 years [J]. Spine (Phila Pa 1976), 2001, 26(14): 1577-1582.
[6] Sciubba DM, et al. Diagnosis and management of metastatic spine disease. A review [J]. J Neurosurg Spine, 2010, 13(1): 94-108.
[7] 林永,胡健,淡付旺,等. 骶骨肿瘤术前栓塞的临床应用研究[J]. 医学影像学杂志, 2009,19(7): 894-895.
[8] 赵玮,王伟中,陈莹,等. 骶骨肿瘤27例供血动脉的血管造影研究[J]. 介入放射学杂志, 2014,23(8): 716-718.
[9] 刘训强,孙敏,王家平,等. 介入栓塞治疗208例肝血管瘤的临床疗效观察[J]. 昆明医科大学学报, 2012,33(5): 107-109+112.
[10] Ozkan E, Gupta S. Embolization of spinal tumors: vascular anatomy, indications, and technique [J]. Tech Vasc Interv Radiol, 2011, 14(3): 129-140.
[11] 杜建伟, 陆宁,王岩. 脊柱血管瘤的诊断与治疗进展[J]. 实用临床医药杂志, 2016,20(1): 186-189.
[12] 乔智红,贾宁阳. 脊柱肿瘤动脉栓塞[J]. 中华临床医师杂志(电子版), 2012,16(22): 7362-7366.
[13] Yang HL, et al. Pre-operative transarterial embolization for treatment of primary sacral tumors [J]. J Clin Neurosci, 2010, 17(10): 1280-1285.
[14] Abramowitz SD, et al. Comparison of four embolic materials at uterine artery embolization by using postprocedural MR imaging enhancement [J]. Radiology, 2009, 250(2): 482-487.
[15] Agdi M, Valenti D, Tulandi T. Intraabdominal adhesions after uterine artery embolization [J]. Am J Obstet Gynecol, 2008, 199(5): 482.e1-3.
[16] 吕银章,王南,徐安辉,等. 椎体肿瘤外科手术前经导管血管栓塞术的应用[J]. 介入放射学杂志, 2014,23(12): 1073-1076.
[17] 杨晶,王宏亮,曹海利,等. 脊柱肿瘤术前选择性动脉栓塞的临床应用价值[J]. 医学影像学杂志, 2016,17(5): 903-906.
[2] Acosta FJ, et al. Comprehensive management of symptomatic and aggressive vertebral hemangiomas [J]. Neurosurg Clin N Am, 2008, 19(1): 17-29.
[3] Fox MW, Onofrio BM. The natural history and management of symptomatic and asymptomatic vertebral hemangiomas [J]. J Neurosurg, 1993, 78(1): 36-45.
[4] 杜建伟, 陆宁,王岩.脊柱血管瘤的诊断与治疗进展[J]. 实用临床医药杂志, 2016, 20(1): 186-189.
[5] Bas T, Aparisi F, Bas JL. Efficacy and safety of ethanol injections in 18 cases of vertebral hemangioma: a mean follow-up of 2 years [J]. Spine (Phila Pa 1976), 2001, 26(14): 1577-1582.
[6] Sciubba DM, et al. Diagnosis and management of metastatic spine disease. A review [J]. J Neurosurg Spine, 2010, 13(1): 94-108.
[7] 林永,胡健,淡付旺,等. 骶骨肿瘤术前栓塞的临床应用研究[J]. 医学影像学杂志, 2009,19(7): 894-895.
[8] 赵玮,王伟中,陈莹,等. 骶骨肿瘤27例供血动脉的血管造影研究[J]. 介入放射学杂志, 2014,23(8): 716-718.
[9] 刘训强,孙敏,王家平,等. 介入栓塞治疗208例肝血管瘤的临床疗效观察[J]. 昆明医科大学学报, 2012,33(5): 107-109+112.
[10] Ozkan E, Gupta S. Embolization of spinal tumors: vascular anatomy, indications, and technique [J]. Tech Vasc Interv Radiol, 2011, 14(3): 129-140.
[11] 杜建伟, 陆宁,王岩. 脊柱血管瘤的诊断与治疗进展[J]. 实用临床医药杂志, 2016,20(1): 186-189.
[12] 乔智红,贾宁阳. 脊柱肿瘤动脉栓塞[J]. 中华临床医师杂志(电子版), 2012,16(22): 7362-7366.
[13] Yang HL, et al. Pre-operative transarterial embolization for treatment of primary sacral tumors [J]. J Clin Neurosci, 2010, 17(10): 1280-1285.
[14] Abramowitz SD, et al. Comparison of four embolic materials at uterine artery embolization by using postprocedural MR imaging enhancement [J]. Radiology, 2009, 250(2): 482-487.
[15] Agdi M, Valenti D, Tulandi T. Intraabdominal adhesions after uterine artery embolization [J]. Am J Obstet Gynecol, 2008, 199(5): 482.e1-3.
[16] 吕银章,王南,徐安辉,等. 椎体肿瘤外科手术前经导管血管栓塞术的应用[J]. 介入放射学杂志, 2014,23(12): 1073-1076.
[17] 杨晶,王宏亮,曹海利,等. 脊柱肿瘤术前选择性动脉栓塞的临床应用价值[J]. 医学影像学杂志, 2016,17(5): 903-906.