颅内成血管细胞瘤术前栓塞术的有效性和安全性评价

Efficacy and safety of preoperative embolization for intracranial hemangioblastomas

目的评价颅内成血管细胞瘤栓塞剂术前栓塞术的有效性和安全性。方法选取2009年10月~2013年10月颅内成血管细胞瘤患者54例,行术前栓塞剂栓塞术治疗的患者24例作为观察组,另外30例采用传统手术进行治疗的患者作为对照组。结果观察组与对照组患者基本情况无统计学意义,具有可比性;观察组术中出血量为335±21 ml,对照组为540±32 ml,两组比较差异具有统计学意义（P=0.001〈0.05）;观察组手术时间为8.35h,对照组手术时间为11.2 h,两组比较差异无统计学意义（P〉0.05）;观察组患者23（95%）例为部分栓塞;观察组术后并发症脑梗塞、再出血、神经功能缺失各1例,发生率为12.5%,对照组术后并发症脑水肿、神经功能缺失各1例,发生率为6.7%,两组相比较差异无统计学意义（P=0.23〉0.05）。结论使用术前栓塞术治疗颅内成血管细胞瘤的患者栓塞程度较高,手术中出血量显著减少;术后再出血、脑梗塞、神经功能缺失、脑水肿等并发症无显著性增加,具有较好的有效性和安全性,可能作为治疗成血管细胞瘤的一种方式。

Objective To investigate the efficacy and safety of preoperative embolization with a variety of embolic agents for intracranial hemangioblastomas. Methods Fifty-four patients who were diagnosed with intracranial hemangioblastomas from October 2009 to October 2013 were enrolled,among whom 24 patients underwent preoperative embolization with embolic agents（ observation group） and30 underwent conventional surgical treatment（ control group）. Results The patients＇ basic information showed no significant difference between the observation group and the control group. Intraoperative blood loss showed a significant difference between the observation group and the control group（ 335 ± 21 ml vs 540 ± 32 ml,P = 0. 001）,and the time of operation showed no significant difference between the two groups（ 8. 35 h vs 11. 2 h,P〉0. 05）. Of all the patients in the observation group,23（ 95%） experienced partial embolization. In the observation group,postoperative complications were cerebral infarction（ 1 case）,rebleeding（ 1 case）,and neurological deficit（ 1 case）,and the incidence rate was 12. 5%. In the control group,postoperative complications were cerebral edema（ 1 case） and neurological deficit（ 1 case）,and the incidence rate was 6. 7%. The incidence of postoperative complications showed no significant difference between the two groups（ P = 0. 23）. Conclusions The patients with intracranial hemangioblastomas who undergo preoperative embolization have a high degree of embolization and significantly reduced intraoperative blood loss,and there is no significant increase in the incidence of complications such as postoperative rebleeding,cerebral infarction,neurological deficit,and cerebral edema. Therefore,preoperative embolization has good efficacy and safety and can be used for the treatment of hemangioblastomas.