Choong Peter F M
Department of Orthapaedics, The University of Melbourne, Melbourne, Australia.
Clin Orthop Relat Res. 2003 Oct(415 Suppl):S245-53. doi: 10.1097/01.blo.0000093058.96273.1f.
Intramedullary fixation of long bone metastases is an effective method of treating or preventing pathologic fractures. An important complication of this technique is the development of pulmonary embolism, which may occur at any number of steps during bone manipulation. Passage of normal marrow contents or tumor into the pulmonary circulation is thought to cause various biochemical, hemodynamic, or physical responses that lead to hypotension, arrythmia, and O2 desaturation. Death is a known risk of this procedure. Numerous surgical and anesthetic strategies have been developed to prevent or treat pulmonary embolic phenomena; however, the most important prophylaxis may be a heightened awareness of this possibility during any procedure that involves intramedullary manipulation of tumor containing bone.
长骨转移瘤的髓内固定是治疗或预防病理性骨折的有效方法。该技术的一个重要并发症是肺栓塞的发生，在骨操作的任何步骤都可能出现。正常骨髓成分或肿瘤进入肺循环被认为会引发各种生化、血流动力学或物理反应，进而导致低血压、心律失常和氧饱和度降低。已知该手术存在死亡风险。已制定了许多外科和麻醉策略来预防或治疗肺栓塞现象；然而，最重要的预防措施可能是在任何涉及对含肿瘤骨进行髓内操作的手术过程中，提高对这种可能性的认识。
