成年难治性癫痫患者立体定向术后生活质量的调查分析  

Analysis of stereotactic surgery on quality of life in adults with refractory epilepsy

作　　者：王一芳[1] 谭启富[2] 许爱刚[1] 王正伟[1] 陈昌[1] 

机构地区：[1]解放军第454医院神经外科,南京210002 [2]南京军区南京总医院神经外科

出　　处：《立体定向和功能性神经外科杂志》2011年第4期206-209,共4页Chinese Journal of Stereotactic and Functional Neurosurgery

基　　金：南京军区医学科学"十一五"科研项目(编号:09MA054)

摘　　要：目的调查分析立体定向手术治疗对成年难治性癫痫患者生活质量的影响。方法对92例无明确致痫灶的成年难治性癫痫患者进行立体定向手术治疗,采用症状自评量表（SCL-90）、癫痫患者生活质量量表-31（QOLIE-31）在手术前及手术后半年、1年、2年、3年、4年、5年对患者进行连续评估。结果尽管部分患者术后癫痫症状不能完全控制,但患者总的生活质量在手术后各阶段均较术前明显提高。手术效果EngelⅠ级患者术后各时间段的生活质量优于Ⅱ~Ⅳ级患者的生活质量。术前具有明显精神症状患者术后各时间段的生活质量与术前无精神症状患者的术后生活质量比较无明显差异。结论对于经术前综合评估不能确定致痫灶,特别是伴有明显精神症状的难治性癫痫患者,立体定向手术治疗是一种有效的治疗手段,可显著改善这部分患者的生活质量。Objective To investigate the affection of stereotactic surgery on quality of life（QOL） in adults with refractory epilepsy.Methods 92 patients of refractory epilepsy with no definitive epileptic focus were treated by stereotactic techniques.Psychiatric evaluation of these patients was performed before surgery,6 months after surgery,and annually for 5 years,using the Symptom Checklist-90（SCL-90） and Quality of Life in Epilepsy-31（QOLIE-31） questionnaires.Results Patients as a whole had a significant improvement in their quality of life after surgery,even if they did not achieve total control of seizures.Nevertheless,those who became seizure free showed even more positive differences in quality of life in comparison with patients in Engel classes Ⅱ~Ⅳ.The quality of life after surgery had no difference between patients without presurgical psychopathology and patients who had a psychiatric diagnosis before suegery.Conclusion For the patients of refractory epilepsy with no definitive epileptic focus,especially for those who complicated by mental disorders,the stereotactic surgery might be an effective treatment method and can improve their quality of life significantly.

关 键 词：癫痫 立体定向术 生活质量 

分 类 号：R742.1[医药卫生—神经病学与精神病学]