超选择性栓塞联合显微手术治疗巨大脑膜瘤

Microsurgery for giant meningiomas after preoperative super-selective embolization

目的探讨巨大脑膜瘤术前栓塞方法、效果及联合显微手术治疗的优势。方法自2013年11月至2014年12月收治颅内巨大脑膜瘤9例,术前应用超选性栓塞肿瘤供血动脉,栓塞术后3 d内显微手术切除脑膜瘤。结果 9例巨大脑膜瘤中,术前达到完全栓塞4例,大部分栓塞5例,无误栓等并发症;Simpson 1级切除5例,2级切除4例。术中出血均在500 ml以内,术中均未输血。术后1 d复查MRI示肿瘤完全切除。结论颅内巨大脑膜瘤血供丰富,术前超选择性栓塞联合显微手术治疗,可显著减少术中出血,提高肿瘤切除率,减少并发症,显著降低围手术期风险。

Objective To summarize the effect of microsurgery after preoperative super-selective embolization on giant meningiomas. Methods A retrospective analysis of the clinical data of 9 patients with giant meningiomas, which were removed by microsurgery within 3 days after super-selective embolization of the arteries supplying blood for the meningiomas, was made. Results The meningiomas were totally removed in all the patients, in whom the intraoperative infusion of blood was not performed and the mistaken embolization did not occur. Conclusions The intraoperative bleeding can be decreased, the operative duration can be shortened and the operative effect can be increased by the preoperative super-selective embolization of the arteries supplying blood for the tumors in the patients with giant meningiomas.