改良式解剖性大脑半球切除术治疗婴儿痉挛性偏瘫伴癫痫的远期疗效  

Long term results in 31 patients on total hemispherectomy modified for infantile hemiplegic epilepsy

作　　者：徐宇伦[1,2,3,4,5,6] 李少武[1,2,3,4,5,6] 陈炳桓[1,2,3,4,5,6] 杨炯达 万选才[1,2,3,4,5,6] 谭郁玲 阎希威 潘映辐[1,2,3,4,5,6] 尹文刚[1,2,3,4,5,6] 刘海一 

机构地区：[1]北京天坛医院神经外科 [2]北京市神经外科研究所 [3]中国科学院心理研究所 [4]解放军总医院计算机室 [5]北京友谊医院神经内科 [6]中国协和医科大学基础医学院

出　　处：《中华外科杂志》1997年第7期421-424,共4页Chinese Journal of Surgery

摘　　要：为了克服解剖性大脑半球切除术的远期合并症，作者对传统术式进行了改良，并对３１例婴儿痉挛性偏瘫伴癫痫的病例进行了疗效的远期随访。结果表明，本术式死亡率为０％，其中２８例癫痫发作完全停止（占９０％），其余３例基本控制。行为异常得到改善、原有偏瘫无加重。神经影像学表现为健侧大脑半球明显向术腔发育；病例的脑干听觉诱发电位Ⅰ波潜伏期（ＰＬ）与对照组间差异无显著性意义（Ｐ＞０．０５）。作者认为，应用本改良法后消除了以往术式造成的巨大硬膜下术腔的病理解剖因素，并证实未发生常见的远期合并症。To overcome long term complications of hemispherectomy, We modified its operative method. The modified hemispherectomy was performed for 31 patients between 1985 and 1992. These patients were studied for 7 years after operation.The results showed total control of seizures in 28 children with chronic epilepsy (90%) or near total control in the others. No deaths or delayed complications were noted but improvement in behavior and hemiplegia. CT and MRI showed marked shift of the remaining hemisphere. On brian stem auditory evoked potentials, the latency of peak Ⅰ was not variant ( P >0 05). The method makes the insulation of the subdural cavity from the ventricular system more reliable, and eliminates the pathological conditions.

关 键 词：去脑皮质术 脑性瘫痪 癫痫 婴儿 

分 类 号：R742.305[医药卫生—神经病学与精神病学]