目的 探讨臀部巨大肿瘤的外科治疗方法.方法 总结11例臀部巨大肿瘤的临床资料,其中血管瘤5例,神经纤维瘤4例,软组织肉瘤2例,采用Seldinger技术,分别选用明胶海绵及线段作为栓塞剂,选择性插管技术栓塞治疗.11例患者术前介入栓塞成功后,再行手术切除肿瘤.结果 本组11例患者行选择供瘤动脉栓塞治疗后瘤体体积变小,张力降低,质地变软,边界相对清楚,且疼痛减轻,避免了术中致命性出血,5例血管瘤术中平均出血约450 ml,4例神经纤维瘤术中平均出血约420ml,2例软组织肉瘤术中出血平均约150ml,术中、术后均未输血,手术切除较彻底,手术时间2～3 h,最大限度地保留正常组织,外形和功能恢复好.10例切口一期愈合,1例切口感染,延迟1周愈合.术后随访4～8个月,未出现肿瘤复发,下肢静脉栓塞等并发症.结论 对臀部巨大肿瘤行介入栓塞联合手术切除治疗,大大降低了手术大出血风险,提高了手术成功率,显著改善生存质量.%Objective To evaluate a combination therapy for huge tumors in the buttocks.Methods A total of 11 patients from our hospital were collected,among them 5 cases were of hemangioma,4 cases of neurofibroma,2 cases of soft tissue sarcoma.Before definite surgical resection all cases received tumor embolization with silk thread and gelatin-sponge article using Seldinger's technic.Subsequently,all patients underwent a successful tumor resection. Results Superselective embolization for all the cases'feeding arteries resulted in recession of the tumors and relatively well-demarcated margins,and all the lumps became softer.and the local pain was alleviated.Surgical resection could be radical with avoidance of fatal intraoperative hemorrhage.The 5 cases of hemangioma had a average operative bleeding of 450 ml,4 cases of neurofibroma had 420 ml,2 cases of soft tissue sarcoma had 150 ml.No patients needed intraoperative and postoperative blood transfusion.The operation time was about 2-3 hours,the normal tissues were preserved and the contour and function of the diseased limbs were very good.One case had a delayed incision healing,and the others had a healing by the first intention.There was no recurrence and other complications (like deep venous thrombosis)during a follow-up period of 4-8 months. Conclusions Surgical resection combined with interventional embolism for the treatment of huge tumors in the buttocks can reduce the risk of bleeding effectively during operation.It can improve the success rate of operation leading to satisfactory results.
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