CAJ | 학술논문

目的：研究大型脑膜瘤的术前栓塞的的应用价值。方法选择55例大型脑膜瘤患者（最大径＞5 cm），分成栓塞组(n=28)和对照组(n=27)，栓塞组术前先予以DSA（digital subtraction angiography）造影了解肿瘤血供情况，并予以PAV颗粒或栓塞微球颗粒（200～300 um）栓塞，对照组未予以栓塞，对比2组肿瘤切除出血量、手术时间，观察手术并发症情况；术后1～2周复查增强MR观察肿块切除程度。结果研究组术中出血量（456±145）mL，明显小于对照组（913±134）mL，差异有统计学意义（P<0.05）。手术时间，研究组与对照组分别为（4.45±2.13）h和（5.23±1.45）h，差异有统计学意义（P<0.05）。栓塞组提高了肿瘤的切除率，4例出现栓塞后颅内高压，头痛加重，1例出现颅神经一过性麻痹，3例出现局部头皮坏死，经支持治疗后均缓解。结论大型脑膜瘤术前血管造影可以了解肿瘤血管情况，指导外科手术切除，栓塞术后可以明显减少术中出血，缩短手术时间，提高肿瘤切除程度。
목적：연구대형뇌막류적술전전새적적응용개치。방법선택55례대형뇌막류환자（최대경＞5 cm），분성전새조(n=28)화대조조(n=27)，전새조술전선여이DSA（digital subtraction angiography）조영료해종류혈공정황，병여이PAV과립혹전새미구과립（200～300 um）전새，대조조미여이전새，대비2조종류절제출혈량、수술시간，관찰수술병발증정황；술후1～2주복사증강MR관찰종괴절제정도。결과연구조술중출혈량（456±145）mL，명현소우대조조（913±134）mL，차이유통계학의의（P<0.05）。수술시간，연구조여대조조분별위（4.45±2.13）h화（5.23±1.45）h，차이유통계학의의（P<0.05）。전새조제고료종류적절제솔，4례출현전새후로내고압，두통가중，1례출현로신경일과성마비，3례출현국부두피배사，경지지치료후균완해。결론대형뇌막류술전혈관조영가이료해종류혈관정황，지도외과수술절제，전새술후가이명현감소술중출혈，축단수술시간，제고종류절제정도。
Objective To study Preoperative embolization of Large-scale meningiomas value. Methods Choose 55 cases of large meningiomas (maximum diameter>5 cm) patients were divided into 28 cases of embolization group and a control group of 27 patients, preoperative embolization group to be pre-DSA angiography of tumor blood supply, and be with PAV particles (200-300 um) embolism, the control group did not give embolism, compared two groups of tumor blood loss, operative time, surgical complications;after 1-2 weeks after lumpectomy extent observed enhanced MR. Results Study group blood loss (456 ± 145) mL was signiifcantly less than the control group (913 ± 134) mL (P<0.05) has a statistically signiifcant difference in operative time, the study group and the control group were (4.45 ± 2.13)h and (5.23 ± 1.45)h, there are signiifcant differences between the two, embolization group increased the rate of tumor resection, 4 cases after embolization of intracranial hypertension, headache aggravated, 1 patient had a transient cranial nerve palsy, three cases partial scalp necrosis, were relieved after supportive treatment. Conclusion Preoperative angiography before a large meningioma tumor vessels can learn to guide surgical resection, embolization can signiifcantly reduce blood loss, shorter operative time, increase the degree of tumor resection.