顽固性癫癎的联合性手术治疗分析  

Clinical effect of surgical operation on intractable epilepsy

作　　者：张景龙[1] 许小兵[1] 张永红[1] 李光[1] 赵占升[1] 李治国[1] 

机构地区：[1]河南焦作煤业集团中央医院,焦作454150

出　　处：《中国实用神经疾病杂志》2007年第2期5-7,共3页Chinese Journal of Practical Nervous Diseases

摘　　要：目的探讨顽固性癫痈的几种联合性手术治疗的临床效果。方法48例顽固性癫痈患者中，10例病灶位于功能区，采用病灶切除加多处软脑膜下横切（MST）；22例病灶及致痈灶位于非功能区，采用病灶、致痈灶切除加周边区MST；11例病灶位于侧裂、前颞叶内或痈灶位于颞叶内，采用病灶、前颞叶切除加颞叶新皮层MST；3例致痈灶广泛存在于一侧或双侧大脑半球，采用广泛性额叶MST加胼胝体前2／3切开。结果本组48例无手术死亡及严重并发症。术后随访0．5～5年，平均3．4年。有效率（发作频率减少50％以上）91．67％，显效率（发作频率减少75％以上）81．25％，效差或无效8．33％。结论顽固性癫痈的联合性手术治疗疗效确切可靠。Objective To observe the clinic curative effect of combination of the surgical operations for treatment of intractable epilepsy. Methods In 48 medically intractable epilepsy patients,lesionectomy and multiple subpial transection（MST）were performed for intractable epilepsy in function areas in 10 patients; lesionectomy, epileptogenic focuses resection and MST in the peri-areas were performed for intractable epilepsy in negative function areas in 22 patients; the epileptogenic focuses located in side crack or the front temporal lobe were treated by lesionectomy and MST（the latest temporal lobe） in 11patients; the epileptogenic focuses located in one or twoside cerebral hemisphere were treated by extensive MST in the bilateral prefrontal lobe with anterior two-thirds corpus callosotomy in 3 patieats. Results There is no operative death and severe complications in 48 patients. The follow- up periods were from 0.5 to 5 years（mean 3.4 years）. The effective rate （there was a more than 500/00 reduction in seizure frequency） was 91.67% ,the significant effective rate （there was a more than 75 % reduction in seizure frequency） was 81.25%, the poor or invalid rate was 8.3%. Conclusion The combination of surgical operations for the treatment of intractable epilepsy is an effective and safe approach.

关 键 词：癫痢 手术治疗 

分 类 号：R742.1[医药卫生—神经病学与精神病学]