巨大脑膜瘤栓塞后手术切除

Preoperative Embolization And Surgical Resection for Larger Meningiomas

目的 探讨巨大脑膜瘤术前栓塞及手术切除的特点。方法 回顾分析 12例巨大脑膜瘤脑血管影像学特点和临床手术治疗资料。脑膜瘤经MR检查发现分别位于前颅窝底、岩部、矢镰旁等处 ,最大直径 5 .6cm～ 9.6cm。所有肿瘤均由多支颈内动脉、颈外动脉分支供血。经选择性血管内途径 ,应用颗粒、明胶海绵、丝线等材料进行栓塞治疗。栓塞后 5～ 8天手术切除。结果 4例肿瘤为完全栓塞 ,8例为部分栓塞。肿瘤全部切除 ,病理证实为脑膜瘤。术中出血量为 30 0～ 10 0 0ml不等。术后MR检查肿瘤完全消失 ,临床症状消退 ,无明显并发症发生。结论 巨大颅内脑膜瘤供血丰富 ,手术切除前应用栓塞治疗可减少术中出血 。

Objective To research preoperative embolization and surgical resection therapy for large meningioma. Methods 12 large meningiomas were detected by MR. The tumors located variously and the size of them ranging from 5.6cm to 9.6 cm. The blood supply came from bi-lateral carotid artery on angiographilic examination.All the tumors underwent preoperative embolization and surgical underwent surgical resection 5～7 days later. And the clinical data were analyzed. Results After demi-embolization (in 8 cases) and complete embolizaiton (in 4 cases), the meningiomas suffered complete resection.During operation the blood losing were from 300 ml to 1000ml.No marked complication occurred after operation and no tumor existed on MR examination. Conclusions The preoperative embolization is beneficial to large miningiomas resection via decreasing the blood supply of tumors, and beneficial to normal cerebral tissue protection.