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目的：通过选择性动脉造影了解脊柱肿瘤的血管造影表现和血供情况，通过选择性动脉栓塞结果的评估探讨影响脊柱肿瘤术前动脉栓塞和疗效的因素及并发症的防治措施。材料与方法： 45例脊柱肿瘤行 49例次 DSA检查和术前选择性动脉栓塞。男 28例，女 17例，平均年龄 44. 3岁 (18～ 78岁 )；恶性肿瘤 35例，良性肿瘤 10例。肿瘤位于骶尾部 27例、胸椎 9例、腰椎 7例、颈椎 2例。行选择性血管造影后用明胶海绵栓塞肿瘤供血动脉，于栓塞后 1～ 5天内进行手术。结果：①脊柱肿瘤主要 DSA表现为供血动脉不同程度增粗、不同程度的肿瘤染色。② 49次 SAE术共栓塞肿瘤血管 115根，除 2例因供血动脉发出脊髓根大动脉和 1例存在多支血供而仅作部分栓塞者外余肿瘤血管均完全栓塞。③ 24例肿瘤完全切除， 21例大部分切除， 3例部分切除， 1例未切除。④手术平均出血量为 1009ml(400～ 2500ml)，无 1例发生术中死亡或术后严重并发症。结论：①脊柱肿瘤详细的 DSA检查有助于治疗方案的制定和所有靶血管的显示。②仔细分析 DSA表现、改进栓塞技术是保证脊柱肿瘤术前动脉栓塞疗效和减少产生并发症的关键。
OBJECTIVE: To evaluate the angiographic performance and blood supply of spinal tumors by selective arteriography, and to evaluate the factors influencing the preoperative arterial embolization and efficacy of vertebral column tumors and the prevention and treatment of complications through selective assessment of arterial embolism. Materials and Methods: Forty-five patients with spinal tumors underwent DSA examination and selective preoperative arterial embolization. There were 28 males and 17 females, with an average age of 44. 3 years (18 to 78 years); 35 malignant tumors and 10 benign tumors. Tumors were located in the sacrococcygeal 27 cases, thoracic 9 cases, lumbar 7 cases, cervical 2 cases. After selective angiography, the tumor feeding artery was embolized with a gelatin sponge, and surgery was performed within 1 to 5 days after embolization. Results: 1 The main DSA of spinal tumors showed different thickening of blood supply arteries and different degrees of tumor staining. Two hundred and forty-nine times SAE was performed to embolize 115 tumor vessels. Except for 2 patients who had sent a large root canal of the spinal cord due to the supplying artery and 1 case had multiple blood supply, only partial embolization was performed. 3 24 tumors were completely resected, 21 were mostly removed, 3 were partially resected, and 1 was not resected. 4 The average blood loss was 1009ml (400-2500ml), and none of the patients had intraoperative death or serious postoperative complications. Conclusions: 1 Detailed DSA examination of spinal tumors will facilitate the development of treatment protocols and the display of all target vessels. 2 careful analysis of DSA performance, improve embolization technology to ensure the efficacy of arterial embolization before spinal tumors and reduce the key to complications.