青少年Lennox-Gastaut综合征的术后癫痫控制、智商与QOL变化及影响因素分析  

Postoperative Seizure Control of Epilepsy and Postoperative Changes of Intelligence Quotient and QOL in Adolescents with Lennox-Gastaut Syndrome and Analysis of the Influencing Factors

作　　者：杜程钢[1] 梁树立[1] 胡晓红[1] 贺赛琳[1] 孙雅静[1] 于晓曼[1] 张绍辉[1] 

机构地区：[1]中国人民解放军总医院第一附属医院,北京100048

出　　处：《实用预防医学》2012年第5期715-717,共3页Practical Preventive Medicine

摘　　要：目的总结分析青少年儿童Lennox—Gastaut综合征（LGS）手术治疗效果，探讨胼胝体切开术（CCT）用于学龄期儿童LGS的价值。方法回顾性研究2003年2月-2007年1月在本院接受胼胝体切开手术治疗的28例13～18岁的Lennox—Gastaut综合征患者，统计病人的发病、检查及手术治疗情况，并统计术后1年（1Fu）和5年（5Fu）癫痫控制情况、智商和生活质量的变化情况及影响因素。结果发病年龄平均5．57岁，病程平均9．71年；影像学异常7例（25．0％）。智商测定结果示中重度精神发育迟滞（FIQ≤50）12例（42．86％）。1FU和5FU时无发作者分别为：17．86％（5例）和10．71％（3例）。同时癫痫发作减少≥50％分别为64．28％（18例）和57．14％（16例）。其中1FU和5FU时两组结果差异无统计学意义（P〉0．05）。1FU时总智商改善46．43％（13／28），总生活质量改善64．28％（18／28）。智商和生活质量的变化与癫痫控制情况无关。术后早期并发症4例，无远期并发症。结论前部CCT可以明显减少青少年LGS患者的癫痫发作，提高QOL和IQ水平，且具有很好的安全性。因此前部CCT可以用于慎重选择的LGS的手术治疗。Objective To summarize and analyze the surgical outcomes of adolescents with Lennox - Gastaut syndrome （LGS）, and to explore the value of corpus callosotomy （CCT） for school - aged children with LGS. Methods Twentyeight patients with LGS aged between 13 and 18 years underwent anterior CCT in the First Affiliated Hospital of General Hcspital of PLA from February 2003 to January 2007 were retrospectively studied. The incidence, the results of examinations,and surgical outcomes of the patients were statistically analyzed. The patients＇ clinical features, including postoperative seizure control at 1 - year （1FU） and 5 year （5FU） and postoperative changes of intelligence quotient （IQ） and QOL, and the related impact factors were statistically analyzed. Results The average age of onset was 5.57 years, and the average course of disease was 9.71 years. There were 7 （25%） patients with abnormal MRI images and 12 （42.86%） patients with a very low IQ （FIQ 450）. The percentages of seizure freedom at 1FU and 5FU reached 17.86% and 10.71%, respectively. The percentages of pa- tients with 50% or more seizure frequency reduction at 1FU and 5FU were 64.28% and 57.14%, respectively. No statistically significant difference was found in seizure control between 1FU and 5FU （P 〉 0.05）. The improvement of FIQ at 1FU was pre- sented in 13 cases （46.43 % ）, and 64.28 % （18/28） patients rendered an improvement in total＇QOL. Postoperative seizure con- trol was not correlated to the changes of IQ and QOL. Postoperative transient complications were seen in 4 cases, but no longterm complication occurred. Conclusions Anterior CCT is promising and ,safe for patients with LGS at adolescence. It is conducive to the patients＇ QOL and IQ improvement and suitable for surgical treatment of LGS.

关 键 词：癫痫外科 青少年 生活质量 胼胝体切开 LG综合征 

分 类 号：R742.1[医药卫生—神经病学与精神病学]