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目的探讨术前脑血管造影及肿瘤供血血管栓塞治疗脑膜瘤的临床效果。方法选取2012年1月—2014年6月湖南省肿瘤医院收治的脑膜瘤患者63例,按治疗方法不同分为Ⅰ组(30例)和Ⅱ组(33例)。Ⅰ组患者术前未行脑血管造影及肿瘤血管栓塞,Ⅱ组患者术前行脑血管造影及肿瘤供血血管栓塞。观察两组患者术中出血量、手术时间、肿瘤切除程度、格拉斯哥预后评分法(GOS)评分及并发症发生情况。结果Ⅱ组患者术中出血量少于Ⅰ组,差异有统计学意义(P<0.05);两组患者手术时间比较,差异无统计学意义(P>0.05);Ⅱ组患者肿瘤切除程度优于Ⅰ组,差异有统计学意义(P<0.05);两组患者GOS评分比较,差异无统计学意义(P>0.05);Ⅱ组患者出现脑梗死、瘤内出血2例,短暂性脑缺血发作及颅神经麻痹1例,栓塞后水肿加重、颅内压增高1例。结论术前脑血管造影及肿瘤供血血管栓塞治疗脑膜瘤的临床效果显著,能减少术中出血、提高肿瘤切除程度,但也存在一定缺陷,应注意其适应证。
Objective To investigate the clinical effect of preoperative cerebral angiography and tumor embolization in the treatment of meningioma. Methods Sixty-three patients with meningioma admitted to Hunan Cancer Hospital from January 2012 to June 2014 were divided into group Ⅰ (n = 30) and group Ⅱ (n = 33) according to the method of treatment. Patients in group Ⅰ had no cerebral angiography and tumor embolization before operation. Patients in group Ⅱ underwent cerebral angiography and tumor embolization before operation. The blood loss, operation time, tumor resection degree, Glasgow prognostic score (GOS) score and complications of the two groups were observed. Results The bleeding volume in group Ⅱ was less than that in group Ⅰ, the difference was statistically significant (P0.05). There was no significant difference in operation time between the two groups (P0.05). The degree of tumor resection in group Ⅱ was better than that of group Ⅰ (P <0.05). There was no significant difference in GOS score between the two groups (P> 0.05). In group Ⅱ, there were cerebral infarction, intratumoral hemorrhage in 2 cases, transient ischemic attack And cranial nerve paralysis in 1 case, post-embolization edema, increased intracranial pressure in 1 case. Conclusion Preoperative cerebral angiography and tumor blood vessel embolization for the treatment of meningioma significant clinical effect, can reduce intraoperative bleeding and improve the degree of tumor resection, but there are also some shortcomings, should pay attention to its indications.