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目的探讨完全以颈外动脉供血或以颈外动脉供血为主的巨大脑膜瘤术前栓塞治疗的临床效果。方法对18例术前经全脑血管造影证实为完全以颈外动脉供血或以颈外动脉供血为主的巨大脑膜瘤,采用明胶海绵栓塞肿瘤供血动脉,栓塞后7d内行手术切除肿瘤。结果栓塞后11例肿瘤染色完全消失,7例肿瘤染色大部分消失。17例栓塞后5～7d顺利实施手术切除肿瘤,1例栓塞后24h内行急诊手术切除肿瘤。术中肿瘤出血减少,所有肿瘤均经手术全切。术后病理观察到肿瘤不同程度的坏死,但有2例栓塞后肿瘤染色消失,而术中肿瘤出血仍较多,且术后病检未发现坏死。术中和术后无严重并发症出现。结论完全以颈外动脉供血或以颈外动脉供血为主巨大脑膜瘤术前栓塞可使术中出血减少,提高手术安全性和肿瘤全切率。
Objective To investigate the clinical effect of preoperative embolization of giant meningioma, which is mainly supplied by external carotid artery or by external carotid artery. Methods Twenty - eight cases of meningiomas, which were completely surgically identified by whole cerebral angiography as external carotid artery or external carotid artery, were embolized with gelatin sponge. The tumor was resected within 7 days after embolization. Results After the embolization of 11 cases of tumor staining completely disappeared, most of 7 cases of tumor staining disappeared. Twenty-seven patients underwent successful surgical resection 5 to 7 days after embolization. One patient underwent emergency surgery to remove the tumor within 24 hours after embolization. Intraoperative bleeding decreased, all tumors were surgically cut. Postoperative pathology observed varying degrees of tumor necrosis, but two cases of tumor staining disappeared after embolization, and intraoperative tumor hemorrhage is still more, and postoperative pathological examination found no necrosis. No intraoperative and postoperative complications occurred. Conclusion Completely external carotid artery or external carotid artery blood supply is the main meningioma preoperative embolization can reduce intraoperative bleeding, improve surgical safety and tumor resection rate.