主要表现为癫痫的脑海绵状血管瘤的治疗  

Management of brain cavernous angiomas presenting epileptic seizures

作　　者：肖其华[1] 黄思庆 王晨[1] 纪卉明[3] 傅西安[1] 吴建东[1] 钱苏荣[1] 游潮[2] 

机构地区：[1]南京医科大学附属苏州医院神经外科,苏州215008 [2]四川大学华西医院神经外科 [3]南京医科大学附属苏州医院检验科

出　　处：《中国神经精神疾病杂志》2010年第12期711-713,共3页Chinese Journal of Nervous and Mental Diseases

摘　　要：目的探讨以癫痫为主要表现的脑海绵状血管瘤合理有效的治疗方法。方法收集我科2003年1月～2009年12月治疗的以癫痫为主要临床表现的脑海绵状血管瘤患者资料35例。单纯药物治疗组(17例):按照血药浓度检测结果进行药物剂量调整及换药,且全部病例疗程都在3年以上;手术联合药物治疗组(18例):严格根据癫痫手术要求进行术前评估及术中监测,切除致痫灶,术后继续使用抗癫药平均1年以上。对两组患者癫痫控制情况及抗癫药使用种类进行对比分析(平均随访2.9年)。结果手术联合药物治疗组患者有16例癫痫得到良好控制,药物治疗组仅6例得到控制(2=8.4777,P<0.05),而且手术联合组较药物治疗组抗癫药使用种类明显减少。结论对于主要表现为癫痫的脑海绵状血管瘤手术联合药物比单纯药物治疗更有效。Objective To analyze retrospectively clinical features of 35 patients with brain cavernous angiomas presenting with seizures and to establish a treatment strategy for brain cavernous angiomas with seizures.Methods There were thirty five patients with brain cavernous angiomas presenting with seizures admitted to our department between 2003 and 2009.Among them,17 patients were treated with medication and 18 were treated with surgery.The mean follow-up period was 2.9 years.Results The percentage of patients with seizure-free outcome was higher in the surgical group than in the medical group（88.9% vs 35.3%）.The number of patients on anticonvulsants was significantly reduced in the surgical group but not in the medical group.Conclusions Surgical intervention may provide greater benefits than medication to patients with brain cavernous angiomas presenting with seizures.

关 键 词：脑海绵状血管瘤 癫痫 手术 

分 类 号：R743.3[医药卫生—神经病学与精神病学]