【摘要】：目的探討腦膜瘤術(shù)前血管栓塞的臨床價值。 方法回顧分析廣西區(qū)人民醫(yī)院神經(jīng)外科于2010年1月至2013年9月收治腦膜瘤68例，前期治療的36例術(shù)前未行腦血管造影及腫瘤血管栓塞，后期治療的32例行腦血管造影及腫瘤供血血管栓塞，其中31例手術(shù)切除腫瘤。觀察兩組患者術(shù)中出血、手術(shù)時間、腫瘤切除程度、出院時GOS評分差異，記錄栓塞相關(guān)并發(fā)癥。 結(jié)果栓塞組有17例采用PVA（150～350μm）水混懸劑，15例采用20%外科膠碘化油混懸劑作為栓塞材料；腫瘤染色消失程度輕度5例，中度9例，大部分11例，完全7例；栓塞組術(shù)中出血量為（361.29ml±133.04）ml，明顯少于對照組的（478.33±195.70）ml（P㩳0.05）；栓塞組手術(shù)時間（5,72±2.42）h與對照組（6.44±2.45）h無差異（P＞0.05）；栓塞組切除程度優(yōu)于對照組（P㩳0.05）；出院時GOS評分兩組間無差異（P＞0.05）；栓塞相關(guān)并發(fā)癥4例（12.5%），經(jīng)相應處理均有效緩解，其中1例未手術(shù)。 結(jié)論腦膜瘤術(shù)前造影可指導術(shù)中對重要血管保護及腫瘤血管處理，而術(shù)前栓塞可減少手術(shù)出血、提高腫瘤切除率，，但應重視其可能引起的并發(fā)癥。
[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 鹵133.04) ml, significantly lower than that in the control group (478.33 鹵195.70) ml (P0. 05). The operative time of the embolization group was (572 鹵2.42) h and that of the control group was (6.44 鹵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.
【學位授予單位】：廣西醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R739.45

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