Glubran胶栓塞高血运脑膜瘤的疗效分析

Efficacy study of Glubran embolization of vascularized meningiomas of intracranial artery branches

目的 探讨通过颈内动脉及椎动脉供血分支超选,使用Glubran胶术前栓塞颅内高血运脑膜瘤的效果及安全性.方法 回顾性分析南方医科大学珠江医院神经外科2011年1月至2015年4月收治的12例通过颈内动脉或椎动脉供血分支进行Glubran胶术前栓塞的高血运脑膜瘤患者的栓塞过程、栓塞术后并发症以及手术效果.结果 共12例术前使用Glubran胶栓塞高血运脑膜瘤的患者,术中平均出血量为972 ml,平均手术时间为7.65 h.1例栓塞术相关出血的患者,经急诊行肿瘤切除及脑室外引流术,术后康复出院.平均随访时间为8.4个月,患者均无肿瘤复发.单纯使用聚乙烯醇颗粒（PVA）术前栓塞的8例患者,平均出血量为1 928 ml,平均手术时间为10.7 h,平均随访时间为17个月,肿瘤复发2例.结论 经颈内动脉或椎动脉供血分支超选,使用Glubran胶行术前栓塞,对以颅内动脉分支供血为主的颅内高血运脑膜瘤可能有良好的血流阻断作用.

Objective To investigate the efficacy and safety of using Glubran for preoperative embolization of vascularized meningiomas through superselective branches of internal carotid artery and vertebral artery. Methods From January 2011 to April 2015, the embolization proeedure, complications after embolization, and surgical outcome of 12 patients with vaseularized meningiomas through blood supply branches of internal carotid artery or vertebral artery for preoperative Glubran embolization admitted to the Department of Neurosurgery, Zhujiang Hospital, Southern Medical University were analyzed retrospectively. Results Twenty patients with meningioma were predominantly fed by the branches of internal carotid artery or vertebral artery, 12 of them were embolized preoperatively with Glubran. The average amount of bleeding during procedure was 972 ml, while the mean operative time was 7.65 h. One patient with embolization related bleeding recovered and was discharged after emergency surgical removal of the tumor and an external ventricular drainage. The average follow-up time of the patients was 8.4 months, and they did not have tumor recurrence. Eight patients were treated with preoperative embolization using the polyvinyl alcohol particles （PVA） alone. The mean amount of bleeding was 1 928 ml, the mean operative time was 10.7 h, and the mean follow-up time was 10.7 h. Two patients had tumor recurrence. Conclusions After internal carotid artery or vertebral artery superselection, using Glubran for preoperative embolization may have a good blood flow blocking effect for the intracranial vascularized meningiomas predominantly fed by intracranial arterial branches