[1]唐 田,古善智,李国文,等.巨型富血供脑膜瘤术前栓塞的临床应用 [J].介入放射学杂志,2017,(04):355-358.
 TANG Tian,GU Shanzhi,LI Guowen,et al.Clinical application of preoperative tumor- feeding artery embolization in treating giant meningiomas with rich blood supply[J].journal interventional radiology,2017,(04):355-358.
点击复制

巨型富血供脑膜瘤术前栓塞的临床应用


()

PDF下载中关闭

分享到:

《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
期数:
2017年04期
页码:
355-358
栏目:
临床研究
出版日期:
2017-04-25

文章信息/Info

Title:
Clinical application of preoperative tumor- feeding artery embolization in treating giant meningiomas with rich blood supply
作者:
唐 田 古善智 李国文 黄满平 黄 斌 熊正平
Author(s):
TANG Tian GU Shanzhi LI Guowen HUANG Manping HUANG Bin XIONG Zhengping
Department of Interventional Radiology, Hunan Provincial Cancer Hospital & Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan Province 410013, China
关键词:
【关键词】 脑膜瘤 栓塞 富血供 新辅助治疗
文献标志码:
A
摘要:
【摘要】 目的 探讨巨型富血供脑膜瘤术前栓塞的的临床应用价值。方法 选择2013年4月至2014年8月收治的71例巨大脑膜瘤(最大径>5 cm)患者,术前MRI提示均强化明显,血供丰富,分成术前栓塞组(研究组)38例和未栓塞(对照组)33例,术前DSA造影确定血供分型为Ⅰ及Ⅱ型脑膜瘤,研究组予以PAV颗粒(200~300 μm)栓塞,对照组仅行脑血管造影,未予以栓塞,观察两组术中出血、肿瘤切除时间及栓塞并发症情况;术后复查MRI观察切除程度。结果 研究组及对照组术中出血量(ml)(562±178)比(833±234)、肿瘤切除时间(h)(5.45±2.13)比(7.23±2.45)、肿瘤切除程度Simpson分级(Ⅲ及Ⅲ以下)27例(27/38,71%)比19例(19/33,57.6%),P<0.05,差异均有统计学意义,7例出现栓塞后脑水肿加重,2例出现头皮缺血性坏死,1例出现术中癫痫发作,对症治疗后均缓解。结论 巨型富血供脑膜瘤术前栓塞可以明显减少术中出血、缩短手术时间,提高脑膜瘤的切除程度,值得在临床推广及应用。

参考文献/References:

[1] 张新良. 脑膜瘤的诊治现状与进展[J]. 临床肿瘤学杂志, 2011, 16: 658- 661.
[2] Louis DN, Ohgaki H, Wiestler OD, et al. The 2007 WHO classification of tumours of the central nervous system[J]. Acta Neuropathol, 2007, 114: 97- 109.
[3] Manelfe C, Guiraud B, David J, et al. Embolization by catheterization of intracranial meningiomas[J]. Rev Neurol (Paris), 1973, 128: 339- 351.
[4] Carli DF, Sluzewski M, Beute GN, et al. Complications of particle embolization of meningiomas: frequency, risk factors, and outcome[J]. AJNR Am J Neuroradiol, 2010, 31: 152- 154.
[5] Simpson D. The recurrence of intracranial meningiomas after surgical treatment[J]. J Neurol Neurosurg Psychiatry, 1957, 20: 22- 39.
[6] Quinones- Hinojosa A, Kaprealian T, Chaichana KL, et al. Pre- operative factors affecting resectability of giant intracranial meningiomas[J]. Can J Neurol Sci, 2009, 36: 623- 630.
[7] Lanzino G. Embolization of meningiomas[J]. J Neurosurg, 2013, 119: 362- 363.
[8] 姚江伟, 李 芸, 吴文甫, 等. 脑膜瘤术前栓塞治疗的临床评价[J]. 中国临床神经外科杂志, 2011, 16: 524- 526.
[9] Wang HH, Luo CB, Guo WY, et al. Preoperative embolization of hypervascular pediatric brain tumors: evaluation of technical safety and outcome[J]. Childs Nerv Syst, 2013, 29: 2043- 2049.
[10] Melo- Guzman G, Escobar de la Garma VH, Padilla- Vazquez F, et al. Preoperative embolization with microspheres of giant supratentorial meningiomas: 5- year experience[J]. Cir Cir, 2014, 82: 372- 380.
[11] Borg A, Ekanayake J, Mair R, et al. Preoperative particle and glue embolization of meningiomas: indications, results, and lessons learned from 117 consecutive patients[J]. Neurosurgery, 2013, 73: 244- 251.
[12] Ashour R, Aziz- Sultan A. Preoperative tumor embolization[J]. Neurosurg Clin N Am, 2014, 25: 607- 617.
[13] Raper DM, Starke RM, Henderson F Jr, et al. Preoperative embolization of intracranial meningiomas: efficacy, technical considerations, and complications[J]. AJNR Am J Neuroradiol, 2014, 35: 1798- 1804.
[14] Pereza RA, Espinosa- Garcia H, Alcala- Cerra G, et al. Emboli- zation of skull- base hypervascular tumors: description of a series of cases and proposal of a therapeutic algorithm[J]. Bol Asoc Med P R, 2013, 105: 20- 27.
[15] Singla A, Deshaies EM, Melnyk V, et al. Controversies in the role of preoperative embolization in meningioma management[J]. Neurosurg Focus, 2013, 35: E17.  

相似文献/References:

[1]唐军,明德国,刘作勤,等.脑动静脉畸形的血管内栓塞治疗[J].介入放射学杂志,2000,(03):144.
[2]王兴华,朱汉洲,李立.腹部手术后消化道出血的介入诊断与治疗[J].介入放射学杂志,2000,(04):240.
[3]王仲朴,王茂强,吴朝阳.经导管子宫动脉栓塞治疗症状性子宫平滑肌瘤的初步经验[J].介入放射学杂志,2000,(04):210.
[4]陈年根,程国勤,周士福,等.肾血管平滑肌脂肪瘤的血管造影表现及栓塞治疗[J].介入放射学杂志,1997,(01):30.
[5]刘福全,梁君,周经志,等.肝、脾及咽部血管瘤的介入治疗[J].介入放射学杂志,1997,(03):142.
[6]高中度,茅爱武,邵维城,等.动脉灌注化疗并栓塞治疗中晚期恶性肿瘤935例临床疗效及并发症分析[J].介入放射学杂志,1998,(03):151.
[7]李明华,陈君彦,顾斌贤,等.颅内动脉瘤可解脱弹簧栓塞治疗——附28例分析[J].介入放射学杂志,1998,(04):194.
[8]陈君彦,方淳,李明华.肢体深静脉血栓形成215例分析[J].介入放射学杂志,1999,(01):12.
[9]朱景伟,刘卫东,范一木,等.经眼上静脉途径栓塞治疗自发性海绵窦硬膜动静脉瘘[J].介入放射学杂志,1999,(02):0.
[10]许奕,刘建民,周晓平,等.电解可脱卸弹簧圈栓塞颅内动脉瘤[J].介入放射学杂志,1999,(02):5.

备注/Memo

备注/Memo:
(收稿日期:2016-10-21)
(本文编辑:俞瑞纲)
更新日期/Last Update: 2017-04-11