插入式微波局部加温切除颅内脑膜瘤的疗效观察

Clinical application of intracranial meningiomas with implantable microwave coagulation

目的：观察插入式微波局部加温切除颅内脑膜瘤的临床疗效。方法：应用插入式微波局部加温切除脑膜瘤１２６例，并与常规手术方法作比较。对６例巨大性脑膜瘤作瘤体内不同距离测温和病理学检查，观察加温时瘤体内温度的变化。结果：微波加温肿瘤全切除１１４例（９０．５％），次全切除９例（７．２％），大部分切除３例（２．３％）。９８例术后复查ＣＴ或ＭＲＩ，随访６个月至５年，其中全切除肿瘤９２例中肿瘤复发６例（６．７％），次全切除肿瘤６例中肿瘤增大１例（１６．６％）。结论：插入式微波局部加温止血效果满意，能明显提高脑膜瘤全切除成功率。

Objective: To explore clinical application of intracranial meningiomas with implantable microwave coagulation (IMC). Methods: Implantable microwave was used to perform resection on 126 cases of intracranial meningiomas, and its result was compared with the conventional surgery method for intracranial meningiomas. It was found during the coagulation treatments that the changes of temperature and histology at different distances from the antenna were not the same. Results: Among the 126 patients, 114(90.5%) were treated with total resection of tumor, 9 (7.1%) with subtotal resection, 3 (2.3%) with greater partial resection. The follow up with CT or MRI period ranged from 6 months to 5 years in 98 patients after operation. The recurrence ratewas 6 7% after total resection, and 16.7% after sbtotal resection. Conclusion: With this new technique, the homeostatic effect during the operation is satisfactory, and blood transfusion can be significally reduced. The success rate for total resection is greatly increased by using IMC, and the rate of tumor recurrence is reduced.