探讨巨大脑膜瘤术前栓塞治疗对手术及患者预后的影响

Effect of Preoperative Embolization on Surgery and Prognosis of Giant Meningioma

目的探讨巨大脑膜瘤术前栓塞治疗对手术及患者预后的影响。方法选取2017年3月25日-2018年4月30日郑州颐和医院神经外科一病区收治的14例巨大脑膜瘤患者的临床资料进行回顾性分析,患者的肿瘤位置主要集中于岩部、颅前窝和矢镰旁,肿瘤直径约7.08~9.62cm,所有患者术前全部接受栓塞治疗,栓塞治疗后的2~3d通过开颅手术将肿瘤切除。结果14例患者中,6例肿瘤完全栓塞、8例部分栓塞;术中平均出血量(576.84±132.75)mL。术后经MR检查显示,颅内肿瘤完全消失,患者的临床症状明显缓解,没有严重的并发症。结论鉴于巨大脑膜瘤的特点,手术治疗前应通过介入造影了解供血情况,术中可避免对重要血管造成损伤。栓塞治疗提高肿瘤的全切率,减少术中出血量与术后并发症,值得应用。

Objective To investigate the effect of preoperative embolization on surgery and prognosis of giant meningioma.Methods From March 25,2017 to April 30,2018,the clinical data of 14 patients with giant meningioma admitted to Department I of Neurosurgery of Zhengzhou Yihe Hospital were retrospectively analyzed.The tumor location of the patient is mainly located near the petrous part,anterior cranial fossa and sagittal falx.The tumor diameter is about 7.08 ~ 9.62cm. All patients received embolization treatment before operation,and the tumor was removed by craniotomy 2-3 days after embolization treatment.Results Of the 14 patients,6 were completely embolized and 8 were partially embolized.The average intraoperative blood loss was (576.84±132.75)mL.After operation,MR examination showed that intracranial tumor completely disappeared,the clinical symptoms of the patients were obviously relieved,and there were no serious complications.Conclusion In view of the characteristics of giant meningioma,blood supply should be understood by interventional angiography before surgical treatment,which can avoid damage to important blood vessels during surgery.Embolization therapy can improve the total resection rate of tumors,reduce intraoperative hemorrhage and postoperative complications,and is worthy of application.