[1]张施远　曾　春　蒋永明.颈外动脉超选择性栓塞对蝶骨嵴脑膜瘤切除术的临床意义[J].中国临床神经外科杂志,2015,(08):459-462.[doi:10.13798/j.issn.1009-153X.2015.08.004]
　ZHANG Shi-yuan,ZENG Chun,JIANG Yong-ming..Value of preoperative superselective embolization through external carotid arteries to surgery for sphenoid ridge meningiomas[J].,2015,(08):459-462.[doi:10.13798/j.issn.1009-153X.2015.08.004]
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颈外动脉超选择性栓塞对蝶骨嵴脑膜瘤切除术的临床意义()
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《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
期数:
2015年08期
页码:
459-462
栏目:
论著
出版日期:
2015-08-25

文章信息/Info

Title:
Value of preoperative superselective embolization through external carotid arteries to surgery for sphenoid ridge meningiomas
文章编号:
1009-153X（2015）08-0459-04
作者:
张施远　曾　春　蒋永明
629000 四川，遂宁市中心医院神经外科（张施远、曾　春、蒋永明）
Author(s):
ZHANG Shi-yuan;  ZENG Chun;  JIANG Yong-ming.
Department of Neurosurgery, Suining Central Hospital, Suining 629000, China
关键词:
蝶骨嵴脑膜瘤; 栓塞; 显微手术; 疗效
Keywords:
Sphenoid ridge meningioma;  Preoperative embolization;  Microsurgery;  Curative effect
分类号:
R 739.41; R 651.1+1
DOI:
10.13798/j.issn.1009-153X.2015.08.004
文献标志码:
A
摘要:
目的 探讨术前超选择性栓塞对蝶骨嵴脑膜瘤切除术的意义。方法 将76例蝶骨嵴脑膜瘤患者随机分成栓塞组（42例）和未栓塞组（34例），两组均行开颅手术切除肿瘤，其中栓塞组切除术前3~7 d应用明胶海绵颗粒进行超选择性栓塞。结果 栓塞后造影示肿瘤染色完全消失27例，大部分或部分消失15例。栓塞组全切率（83.33%，35/42；Simpson分级Ⅰ+Ⅱ级）明显高于未栓塞组（38.24%，13/34；P<0.05）。栓塞组术中失血量[（321.32±87.29）ml]较未栓塞组[（648.76±67.21）ml]明显减少（>P<0.01）。栓塞组术后住院时间[（12.42±4.54）d]较未栓塞组[（19.82±6.23）d]明显缩短（>PP<0.01）。所有患者术后随访6个月~2年，栓塞组kps评分显著优于未栓塞组（>P<0.05）。>结论 对于蝶骨嵴脑膜瘤，术前超选择性栓塞有助于减少术中出血，减少术后并发症，提高手术疗效。
Abstract:
Objective To investigate the clinical value of preoperative superselective embolization through external carotid arteries to surgery for sphenoid ridge meningiomas. Methods Seventy-six patients with sphenoid ridge meningiomas were randomly divided into two groups, i.e. the preoperative embolization group (n=24), in which the patients received the Gelfoam particles embolization of the meningiomas through the external carotid arteries from 3 to 7 days before the surgery and control group (n=34) in which the patients did not receive preoperative embolization. The operative outcomes, intraoperative blood loss volume and hospital stay were compared between both the groups. Results Of 42 patients in the embolization group, 26 (61.9%) received Simpson grade Ⅰ resection of the tumors, 9 (21.4%) grade Ⅱ, 5 (11.9%) grade Ⅲ and 2 (4.7%) grade Ⅳ. Of 34 patients in the control group, 6 (17.6%) received Simpson grade Ⅰ resction of the tumors, 7 (20.6%) grade Ⅱ, 4 (11.8%) grade Ⅲ, and 17 (50.0%) grade Ⅳ. The rates of postoperative complication occurrence in the embolization and control groups were 11.9% (5/42) and 61.8% (21/34) respectively. The intraoperative blood loss volumes in the embolization and control groups were (321.32±87.29) ml and (648.76±67.21) ml respectively. The average stays in the embolization and control groups were (12.4±4.54) days and (19.82±6.23) days respectively. Karnofsky performance score was 100 points in 34 patients (80.94%), 90 in 6 (14.29%), 80 in 2 (4.76%) in the embolization group and 100 in 14 (41.18%), 90 in 5 (14.71%), 80 in 4 (11.76%), 70 in 4 (11.76%), 60 in 2 (5.88%), 40 in 3 (8.82%) and zere in 2 (5.88%) in th control group from 6 to 24 months after the surgery. The outcomes of surgery and prognosis were significantly better in the embolization group than those in the control group (P<0.05). the="" rate="" of="" postoperative="" complication="" occurrence,="" volume="" intraoperative="" blood="" loss="" and="" average="" stay="" were="" significantly="" fewer="" in="" embolization="" group="" than="" those="" control="" (P

参考文献/References:

[1] Manelfe C, Lasjaunias P, Ruscalleda J. Preoperative embo- lization of intracranial meningiomas [J]. Am J Neuroradiol, 1986, 7(5): 963-972.
[2] Simpson D. The recurrence of intracranial meningiomas after surgical treatment [J]. J Neurol Neurosurg Psychiatry, 1957, 20(1): 22-39.
[3] 毛承亮，唐　凯，詹升全，等. 巨大内侧型蝶骨嵴脑膜瘤的 外科治疗[J]. 中国微侵袭神经外科杂志，2013，18（8）： 358-360.
[4] 齐铁伟，郭少雷，林佳平，等. 选择性栓塞联合显微手术切 除颅内脑膜瘤的临床研究[J]. 中华显微外科杂志，2005， 28（5）：180-181.
[5] Bendszus M, Rao G, Burger R, et al. Is there a benefit of preoperative meningioma embolization [J]? Neurosurgery, 2000, 47(6): 1306-1312.
[6] 曾宪强，段传志. 脑膜瘤术前颈外供血动脉栓塞[J]. 中国 微侵袭神经外科杂志，2007，12（11）：513-514.
[7] 钟景灿，王毛毛，张嘉林. 颅底肿瘤术前选择性血管栓塞 术的应用体会(附32例报告)[J]. 中国微侵袭神经外科杂 志，2004，9（12）：564-565.
[8] 凌　峰. 介入神经放射影像学[M]. 北京：人民卫生出版 社，1999. 130-131.
[9] 李骁雄，入江惠子，邱永明，等. 脑膜瘤术前栓塞[J]. 上海 交通大学学报（医学版），2007，27（4）：478-480.

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备注/Memo

备注/Memo:
基金项目：四川省卫生厅科研课题（140106）
通讯作者：曾　春，E-mail：thriller999@163.com
更新日期/Last Update: 2016-08-25