难治性癫痫外科治疗的长期效果:一项6年随访研究结果  

Long-term outcomes of epilepsy surgery:a six-year's follow-up of 66 patients

作　　者：王宝锋[1] 金义超[1] 兰津[1] 王桂松[1] 徐纪文[1] 周洪语[1] 田鑫[1] 赵晨杰[1] 

机构地区：[1]上海交通大学医学院附属仁济医院神经外科,上海200127

出　　处：《立体定向和功能性神经外科杂志》2011年第1期18-21,共4页Chinese Journal of Stereotactic and Functional Neurosurgery

摘　　要：目的总结分析难治性癫痫外科治疗的方法及效果,为进一步的临床实践提供指导。方法综合临床症状学、神经电生理和神经影像学等方法,对66例难治性癫痫患者进行致痫灶定位和外科手术治疗,术后进行长期随访,平均随访时间为6年。结果 1例患者在随访期间因意外窒息死亡,余结果如下:谭启富标准:满意22例(33.8%),显著改善33例(50.8%),良好6例(9.2%),较差2例(3.1%),无改善2例(3.1%);Engel标准:Ⅰ级21例(32.3%),Ⅱ级13例(20.0%),Ⅲ级24例(36.9%),Ⅳ级7例(7.8%)。术后出现的并发症有偏瘫、失语、感染等,但均在短期内恢复。结论综合临床症状、神经电生理和神经影像学检查,可以精确定位癫痫患者的致痫灶,进一步选择合适的手术方法可以使难治性癫痫的外科治疗获得良好的效果。Objective To analyze the methods and long--term outcomes of surgical treatment for refractory epilepsy. Methods Symptomatology, neuroelectrophysiology and neuroimaging were used to evaluate the origin of epileptogenic loci comprehensively. 66 cases with refractory epilepsy accepted the surgical treatment, including temporal lobe surgery, corpus callosotomy et al. Then we had a long--term follow--up of six--year. Results Except one case died of accidental asphyxia during the follow--up, others had a good result. According to the standard of Tan Qifu, the satisfaction were 22 cases （33. 8%）, significant improvement were 33 cases（50. 8%）, good were 6 cases （9.2%）, mild were 2 cases （3. 1%）, no change were 2 cases （3. 1%） ; Engel I 21 cases （32.3%）, Engel II 13 cases（20. 0%） Engel III 24 cases（36.9%） Engel IV 7 cases（7. 8%）. No permanent complication was found. Conclusion By comprehensive application of clinical symptom, neuroelectrophysiology and neuroimaging, the origin of epileptongenic loci can be localized precisely, combined adaptive operation, we can get good outcomes of epilepsy surgery.

关 键 词：难治性癫痫 癫痫外科 长期随访 

分 类 号：R742.1[医药卫生—神经病学与精神病学]