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目的分析骶骨肿瘤术后切口并发症的原因。方法2003年1月～2008年12月23例骶骨肿瘤行手术切除,手术时平均年龄42岁(16～68岁);男性10例,女性13例。其中脊索瘤8例、骨巨细胞瘤6例、神经纤维瘤1例、恶性神经鞘瘤1例,转移瘤3例、骨母细胞瘤1例、骨肉瘤2例、软骨肉瘤1例。统计分析患者性别,年龄,肿瘤性质,有无糖尿病,肥胖,吸烟,是否应用激素,以前是否有过手术,放疗,术前是否行化疗,动脉栓塞,手术时间,出血量,手术入路,有无脑脊液漏,术后膀胱和肠道功能情况。应用Logistic回归分析了解以上因素与术后切口并发症的关系。结果6例患者(26%)术后出现切口并发症。增加并发症发生的因素有以前做过手术(P=0.016;OR8.01),手术时间>3h(P=0.036;OR3.79),年龄>50岁(P=0.076;OR1.59),术后膀胱和肠道功能障碍(P=0.089;OR2.53)。结论骶骨肿瘤切除手术切口并发症与再次手术,手术时间长,高龄患者以及术后膀胱和肠道功能障碍因素相关。
Objective To analyze the causes of incision complications after sacral tumor. Methods From January 2003 to December 2008, 23 patients with sacral tumors underwent surgical resection. The mean age at surgery was 42 years (range 16-68 years). There were 10 males and 13 females. Including 8 cases of chordoma, giant cell tumor in 6 cases, 1 case of neurofibroma, 1 case of malignant schwannoma, 3 cases of metastatic tumor, osteoblastoma in 1 case, osteosarcoma in 2 cases, chondrosarcoma in 1 case. Statistical analysis of patients with gender, age, tumor nature, with or without diabetes, obesity, smoking, whether the use of hormones, whether there had been surgery before, radiotherapy, preoperative chemotherapy, arterial embolism, operation time, blood loss, surgical approach, there No cerebrospinal fluid leakage, postoperative bladder and intestinal function. Logistic regression analysis to understand the above factors and postoperative complications of incision. Results Six patients (26%) had postoperative complications of incision. The factors that increased the incidence of complications were surgery (P = 0.016; OR8.01), operation time> 3h (P = 0.036; OR3.79), age> 50 years (P = 0.076; OR1.59) Post-bladder and bowel dysfunction (P = 0.089; OR 2.53). Conclusions The complications of sacrectomy for resection of sacral tumor are related to the reoperation, operation time, elderly patients and postoperative bladder and intestinal dysfunction.