Basile Antonio, Rand Thomas, Lomoschitz Fritz, Toma Cyril, Lupattelli Tommaso, Kettenbach Joachim, Lammer Johannes
Division of Angiography and Interventional Radiology, University of Vienna Medical School, Währinger Gürtel 18-20, A-1090 Vienna, Austria.
Cardiovasc Intervent Radiol. 2004 Sep-Oct;27(5):495-502. doi: 10.1007/s00270-003-0147-1. Epub 2004 Jul 30.
The aim of this study was to compare the efficacy of trisacryl gelatin microspheres versus polyvinyl alcohol particles (PVA) in the preoperative embolization of bone neoplasms, on the basis of intraoperative blood loss quantified by the differences in preoperative and postoperative hematic levels of hemoglobin, hematocrit and erythrocytes count. From January 1997 to December 2002, preoperative embolization of bone tumors (either primary or secondary) was carried out in 49 patients (age range 12/78), 20 of whom were treated with trysacril gelatin microspheres (group A) and 29 with PVA particles (group B). The delay between embolization and surgery ranged from 1 to 13 days in group A and 1 to 4 days in group B. As used in international protocols, we considered hematic levels of hemoglobin, hematocrit and erythrocytes count for the measurement of intraoperative blood loss then the differences in pre- and postoperative levels were used as statistical comparative parameters. We compared the values of patients treated with embospheres (n = 10) and PVA (n = 18) alone, and patients treated with (group A = 10; group B = 11) versus patients treated without other additional embolic materials in each group (group A = 10; group B = 18). According to the Student's t-test ( p < 0.05), the difference of hematic parameters between patients treated by embospheres and PVA alone were significant; otherwise there was no significant difference between patients treated with only one embolic material (embospheres and PVA) versus those treated with other additional embolic agents in each group. The patients treated with microspheres had a minor quantification of intraoperative blood loss compared to those who received PVA particles. Furthermore, they had a minor increase of bleeding related to the delay time between embolization and surgery. The use of additional embolic material did not improve the efficacy of the procedure in either group of patients.
本研究的目的是根据术前和术后血红蛋白、血细胞比容及红细胞计数的血液水平差异所量化的术中失血量，比较三丙烯酸明胶微球与聚乙烯醇颗粒（PVA）在骨肿瘤术前栓塞中的疗效。1997年1月至2002年12月，对49例患者（年龄范围12/78岁）进行了骨肿瘤（原发性或继发性）的术前栓塞，其中20例接受三丙烯酸明胶微球治疗（A组），29例接受PVA颗粒治疗（B组）。A组栓塞与手术之间的间隔时间为1至13天，B组为1至4天。按照国际方案，我们将血红蛋白、血细胞比容及红细胞计数的血液水平用于术中失血量的测量，然后将术前和术后水平的差异用作统计学比较参数。我们比较了单独使用栓塞微球（n = 10）和PVA（n = 18）治疗的患者，以及每组中使用栓塞微球治疗的患者（A组 = 10；B组 = 11）与未使用其他额外栓塞材料治疗的患者（A组 = 10；B组 = 18）。根据学生t检验（p < 0.05），单独使用栓塞微球和PVA治疗的患者血液参数差异显著；否则，每组中仅使用一种栓塞材料（栓塞微球和PVA）治疗的患者与使用其他额外栓塞剂治疗的患者之间无显著差异。与接受PVA颗粒的患者相比，接受微球治疗的患者术中失血量的量化值较小。此外，他们与栓塞和手术之间的延迟时间相关的出血增加较少。在两组患者中，使用额外的栓塞材料均未提高该手术的疗效。
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