目的探讨术前数字减影血管造影(DSA)检查及选择性栓塞在大型脑膜瘤手术治疗中的作用。方法回顾性分析13例大型脑膜瘤患者的临床资料,所有患者均常规行术前DSA检查,其中10例患者行选择性肿瘤供血动脉栓塞,栓塞后4-7d行手术切除肿瘤。结果 10例栓塞患者栓塞后8例染色完全消失,2例大部分消失,所有肿瘤经手术全切,栓塞患者术中出血明显少于未栓塞患者(P〈0.05),术中及术后无严重并发症。术后病理检查可见肿瘤不同程度坏死。结论选择性栓塞可明显减少脑膜瘤手术治疗的术中出血。
Objective To explore the role of the preoperative DSA examination and selected embolization in surgical treatment of intracranial huge meningiomas.Methods The clinical materials of 13 patients was collected and analyzed.Preoperative DSA was carried out in all cases,10 of 13underwent selected preoperative embolization,the meningiomas were totally excised by surgery 4to7 days after the embolization.Results After the embolization,DSA showed that the blood fed to the tumors was completely blocked in 8cases,and in great part in 2cases.All tumors were totally removed,the bleeding during operation was significantly decreased in patients who underwent preoperative embolization compared to the patients without embolization(P〈0.05).Necrosis in different degree of meningiomas was found in postoperative pathological examination.There were no severe complications occurred during and after operations in all patients.Conclusion Preoperative selective embolization could significantly decrease the bleeding during operations.