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目的:探讨数字减影血管造影技术(DSA)在脊柱肿瘤诊断与外科治疗中的应用价值。方法:对38例脊柱肿瘤患者术前行DSA检查,有主干血管供血或血运丰富的27例行血管栓塞+手术治疗,11例无主干血管供血者直接行手术切除。结果:27例行栓塞后再手术者无术中、术后并发症,11例直接切除病例中1例术后出现伤口感染。平均随访13个月,栓塞+手术治疗组有1例转移瘤患者术后1年复发;11例直接切除病例中1例转移瘤患者术后8个月复发。结论:DSA在脊柱肿瘤治疗过程中对确定肿瘤部位、范围和区别肿瘤良恶性有较大的应用价值;术前应用血管栓塞治疗椎体血管瘤及脊柱恶性肿瘤可明显减少术中出血,缩短手术时间,并可有效地防止肿瘤复发。
Objective: To investigate the value of digital subtraction angiography (DSA) in the diagnosis and surgical treatment of spinal tumors. Methods: Thirty-eight patients with spinal tumors underwent preoperative DSA. There were 27 patients undergoing vascular embolization and surgical treatment with blood supply to the main artery or blood vessels, and 11 patients without primary blood vessels were directly surgically removed. Results: There were no intraoperative and postoperative complications in 27 patients who underwent reoperation after embolization. One case of 11 cases of direct resection showed wound infection after operation. The patients were followed up for an average of 13 months. One patient with metastatic disease in the embolization + surgery group had recurrence one year after operation. One patient with metastases in 11 patients undergoing direct resection recurred 8 months after operation. Conclusion: DSA has great value in determining the location, range and differentiation of benign and malignant tumors in the treatment of spinal tumors. Preoperative application of vascular embolization in the treatment of vertebral hemangiomas and spinal malignancies can significantly reduce intraoperative bleeding and shorten the operation Time, and can effectively prevent tumor recurrence.