术前脑血管造影及肿瘤供血血管栓塞治疗脑膜瘤的临床效果

Effect of preoperative cerebral angiography and tumor feeding vascular embolization in treating meningioma

目的探讨术前脑血管造影及肿瘤供血血管栓塞治疗脑膜瘤的临床效果。方法选取2012年1月—2014年6月湖南省肿瘤医院收治的脑膜瘤患者63例,按治疗方法不同分为Ⅰ组(30例)和Ⅱ组(33例)。Ⅰ组患者术前未行脑血管造影及肿瘤血管栓塞,Ⅱ组患者术前行脑血管造影及肿瘤供血血管栓塞。观察两组患者术中出血量、手术时间、肿瘤切除程度、格拉斯哥预后评分法(GOS)评分及并发症发生情况。结果Ⅱ组患者术中出血量少于Ⅰ组,差异有统计学意义(P<0.05);两组患者手术时间比较,差异无统计学意义(P>0.05);Ⅱ组患者肿瘤切除程度优于Ⅰ组,差异有统计学意义(P<0.05);两组患者GOS评分比较,差异无统计学意义(P>0.05);Ⅱ组患者出现脑梗死、瘤内出血2例,短暂性脑缺血发作及颅神经麻痹1例,栓塞后水肿加重、颅内压增高1例。结论术前脑血管造影及肿瘤供血血管栓塞治疗脑膜瘤的临床效果显著,能减少术中出血、提高肿瘤切除程度,但也存在一定缺陷,应注意其适应证。

Objective To explore the effect of preoperative cerebral angiography and tumor feeding vascular embohzation in treating meningioma. Methods A total of 63 patients with meningioma were selected in Hu＇nan Provincial Tumor Hospital from January 2010 to June 2014, according to the treatment methods, the patients were divided into I group （30 cases） and Ⅱ group （33 cases）. I group did not received cerbral angiography or tumor vascular embolization, [[ group received cerebral angiography and tumor feeding vascular embolization. Tintraoperative blood loss, operation time, tumor degree of resection, glasgow outcome scale （GOS） score and occurrence of complications of two groups were compared. Results Tintraoperative blood loss of 1] group was less than that of I group （ P 〈 0.05 ） , operation time showed no significant differences between the two groups （ P 〉 0.05 ）, tumor degree of resection of Ⅱ group was better than that of I group （ P 〈 0. 05 ） , GOS score showed no significant differences between the two groups （ P 〉 0.05 ）, Ⅱ group occourred cerebral infarction, hemorrhage in tumors in 2 cases, transient ischemic attack and cranial nerve paralysis in 1 case, edema after embolization aggravated, intraeranial hypertension in 1 ease. Conclusion Preoperative cerebral angiography and tumor feeding vascular embolization have notable curative effect in the treatment of meningioma, can reduce operative hemorrhage, increase tumor degree of resection, but there are certain defects, its indication should be paid attention to.