摘要
目的探讨完全以颈外动脉供血或以颈外动脉供血为主的巨大脑膜瘤术前栓塞治疗的临床效果。方法对18例术前经全脑血管造影证实为完全以颈外动脉供血或以颈外动脉供血为主的巨大脑膜瘤,采用明胶海绵栓塞肿瘤供血动脉,栓塞后7d内行手术切除肿瘤。结果栓塞后11例肿瘤染色完全消失,7例肿瘤染色大部分消失。17例栓塞后5～7d顺利实施手术切除肿瘤,1例栓塞后24h内行急诊手术切除肿瘤。术中肿瘤出血减少,所有肿瘤均经手术全切。术后病理观察到肿瘤不同程度的坏死,但有2例栓塞后肿瘤染色消失,而术中肿瘤出血仍较多,且术后病检未发现坏死。术中和术后无严重并发症出现。结论完全以颈外动脉供血或以颈外动脉供血为主巨大脑膜瘤术前栓塞可使术中出血减少,提高手术安全性和肿瘤全切率。
Objective To investigate the effect of preoperative embolization of intracranial giant meningiomas for which blood was supplied completely or dominantly by external carotid arteries（ECA） on the microsurgery and its outcome. Methods The arteries which supplied blood for the meningiomas were superselectively embolized by gelfoam before the surgery in 18 patients with intracranial giant meningiomas for which blood was supplied completely or dominantly by ECA. The giant meningiomas were excisesd by surgery within 7 days after the embolization. Results After the embolization, DSA showed that the blood fed to the tumors were completely blocked in 11 patients, and in great part in 7 patients. The meningiomas were totally removed 5-7 days after the embolization in 17 patients and one was totally removed by emergent surgery in 1 patient within 24 hours after the embolization. Bleeding were significantly decreased during the operations. The postoperative pathological examination showed that necrosis in different degree occurred in the meningiomas. No severe complication occurred during and after the operations in all the patients. Conclusions Preoperative embolization of the meningiomas for which blood is supplied completely or dominantly by ECA can make bleeding decrease and enhance surgical safety and the rate of total resection of the tumors in the patients with intracranial giant meningiomas.
出处
《中国临床神经外科杂志》
2009年第6期337-338,342,共3页
Chinese Journal of Clinical Neurosurgery
关键词
颅内巨大脑膜瘤
术前栓塞
手术
Intracranial giant meningioma
Preoperative embolization
Surgery
