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目的探讨超选择性微导管插管术前栓塞富血供脑膜瘤的效果与治疗经验。方法 28例富血供脑膜瘤患者(男11例,女17例,年龄14～63岁,平均51.2岁),先行全脑血管造影(DSA),随后将微导管超选至肿瘤的供血动脉进行栓塞。栓塞材料包括聚乙烯醇(PVA)颗粒、弹簧圈及液态栓塞系统(商品名:Onyx)胶,可根据术中情况联合使用。栓塞后3～5d行外科手术切除肿瘤。结果栓塞术后,肿瘤染色完全消失16例,大部分消失9例,部分消失3例。无与介入栓塞相关的并发症发生。肿瘤全切26例,次全切除2例。术中肿瘤出血明显减少,其中11例患者切除瘤体时基本未出血,平均出血量约500mL,手术时间较未行术前栓塞患者明显缩短。结论微导管超选择插管栓塞富血供脑膜瘤能有效的闭塞肿瘤的血管床,有效地减少外科手术中的出血,可作为富血供脑膜瘤切除术前的一种重要的、常规性的辅助措施。
Objective To investigate the effect and therapeutic experience of superselective microcatheter embolization before embolization for meningiomas. Methods Twenty-eight patients with meningioma were enrolled in this study. Among them, 11 were male and 17 were female, aged from 14 to 63 years old (average 51.2 years). First, DSA was performed. Subsequently, microcatheter was superselected to the artery of the tumor embolism. Embolization materials include polyvinyl alcohol (PVA) particles, coils, and liquid embolism systems (trade name: Onyx), which can be used in conjunction with the surgery. 3 to 5 days after embolization surgical removal of the tumor. Results After embolization, tumor staining completely disappeared in 16 cases, most disappeared in 9 cases, partially disappeared in 3 cases. No complications associated with embolic occlusion occurred. Total resection of tumor in 26 cases, subtotal resection in 2 cases. Tumor hemorrhage was significantly reduced during surgery, of which 11 cases of patients with tumor removal was basically no bleeding, the average amount of bleeding about 500mL, surgery time was shorter than before embolization. Conclusion Microcatheter superselective intubation embolization of blood for meningioma can effectively occlude the tumor vascular bed, effectively reducing the bleeding during surgery, can be used as a rich blood for meningioma resection before an important and routine Assistive measures.