脑膜瘤术前栓塞32例临床分析

发布时间：2018-11-16 21:43

【摘要】：目的探讨脑膜瘤术前血管栓塞的临床价值。方法回顾分析广西区人民医院神经外科于2010年1月至2013年9月收治脑膜瘤68例，前期治疗的36例术前未行脑血管造影及肿瘤血管栓塞，后期治疗的32例行脑血管造影及肿瘤供血血管栓塞，其中31例手术切除肿瘤。观察两组患者术中出血、手术时间、肿瘤切除程度、出院时GOS评分差异，记录栓塞相关并发症。结果栓塞组有17例采用PVA（150～350μm）水混悬剂，15例采用20%外科胶碘化油混悬剂作为栓塞材料；肿瘤染色消失程度轻度5例，中度9例，大部分11例，完全7例；栓塞组术中出血量为（361.29ml±133.04）ml，明显少于对照组的（478.33±195.70）ml（P㩳0.05）；栓塞组手术时间（5,72±2.42）h与对照组（6.44±2.45）h无差异（P＞0.05）；栓塞组切除程度优于对照组（P㩳0.05）；出院时GOS评分两组间无差异（P＞0.05）；栓塞相关并发症4例（12.5%），经相应处理均有效缓解，其中1例未手术。结论脑膜瘤术前造影可指导术中对重要血管保护及肿瘤血管处理，而术前栓塞可减少手术出血、提高肿瘤切除率，，但应重视其可能引起的并发症。
[Abstract]:Objective to evaluate the clinical value of preoperative vascular embolization in meningioma. Methods from January 2010 to September 2013, 68 cases of meningioma were treated in the neurosurgery department of Guangxi people's Hospital. 32 patients were treated with cerebrovascular angiography and embolism of tumor blood supply, 31 of them underwent resection of tumor. The intraoperative bleeding, operative time, tumor resection degree, GOS score at discharge were observed, and the complications of embolism were recorded. Results in the embolization group, 17 cases were treated with PVA (150 ~ 350 渭 m) water suspension, 15 cases with 20% surgical gum iodized oil suspension, 5 cases with mild tumor staining, 9 cases with moderate degree, 11 cases with most of them and 7 cases with complete tumor staining. The amount of intraoperative bleeding in the embolization group was (361.29ml 卤133.04) ml, significantly lower than that in the control group (478.33 卤195.70) ml (P0. 05). The operative time of the embolization group was (572 卤2.42) h and that of the control group was (6.44 卤2.45) h (P > 0. 05), the degree of excision in the embolization group was better than that of the control group (p0. 05), and there was no difference in the GOS score between the two groups at discharge (P > 0. 05). Four cases (12.5%) were treated with embolization related complications, and 1 case was not operated on. Conclusion preoperative angiography of meningiomas can guide the protection of important vessels and the treatment of tumor vessels during operation, while preoperative embolization can reduce operative bleeding and increase the rate of tumor resection, but we should pay attention to the possible complications.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R739.45

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