多种术式结合治疗外伤后癫痫  

Combined several operations for post-traumatic epilepsy

作　　者：潘进钱[1] 郑伟明[1] 张晓微[1] 

机构地区：[1]浙江省温州医学院附属第一医院,温州325000

出　　处：《浙江创伤外科》2006年第1期4-7,共4页Zhejiang Journal of Traumatic Surgery

摘　　要：目的评价多种术式结合使用治疗外伤后癫痫的效果。方法21例患者根据术前致痫灶的初步定位和术中皮层脑电及深部电极的监测结果,分别采用以下5种不同的术式:①疤痕及周围皮层切除7例;②疤痕及周围皮层切除+多软膜下横切术(MST)8例;③前颞叶、杏仁核-海马切除4例;④神经导航下选择性杏仁核-海马切除1例;⑤胼胝体前部切开+MST+皮层热灼1例。结果术后随访3个月至2年,疗效满意的9例(43%),显著改善的7例(33%),良好的3例(14%),效差的1例(5%),无改善的1例(5%)。术后无死亡病例。有8例出现暂时性的功能障碍,但均在4周内恢复正常。结论多种术式结合治疗外伤后癫痫安全有效。Objective Tn evaluate the surgieal outcomes of the combined several operations for post-traumatic epilepsy during one surgery. Methods According to the preoperative tentative location uf epileptogenic focus and the mornitoring of intraoperative electrocorticography and depth electrodes, 21 seizure patients were performed with different surgical methods,including （1）epileptogenic focus resection in 7 cases,（2）epileptogenic focus resection combined with multiple subpial transection （MST） in 8 eases.（3）anterior temporal lobectomy combined with amygdalo-hippocampectomy in 4 cases, （4）seleetive amygdalo-hippocampeetmny was performed under neuronavigation in 1 case.（5）anterior callosotomy combined with MST and bipolar coagulation on funtional eortexes in 1 case. Results 21 patients were followed up from 3 months to 2 years postoperatively , satisfactory outcome in 9 cases （42,9%）,marked improvement in 7 eases （33.3%）,impvovement in 3 cases （14.3%）,slight improvement in 1 case （4.8%） and no improvement in 1 case （4.8%）.There was no mortality caused by the procedure. 8 cases had side-effects temporarily,but all recovered in four weeks after surgery. Conclusion For post-traumatic epilepsy,the combined several operations is effective on seizure control and as safe as regular seizure surgery.

关 键 词：外伤后癫痫 外科手术 

分 类 号：R742.1[医药卫生—神经病学与精神病学]