改良小骨窗胼胝体切开术治疗难治性癫痫  

Corpus callosotomy by improved small bone window in patients with refractory epilepsy

作　　者：周建鹏[1] 周洪语[1] 钟志宏[1] 王冉[1] 赵晨杰[1] 田鑫[1] 王桂松[1] 徐纪文[1] 江基尧[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：《中华神经医学杂志》2012年第9期920-922,共3页Chinese Journal of Neuromedicine

摘　　要：目的探讨胼胝体切开治疗难治性癫痫的改良手术方法。方法回顾性分析上海交通大学医学院附属仁济医院神经外科自2003年7月至2010年7月治疗的36例难治性癫痫患者临床资料．对改良的小骨窗胼胝体切开术皮肤切口、骨瓣设计、术式优缺点及术中注意事项等情况进行总结。结果36例患者术中均采用改良的“S”形或近似马蹄形切15、梯形小骨窗（上底边、下底边、高分别为2cm、4cm、2．5cm），在显微镜下经纵裂人路切开胼胝体前部2／3。术后随访9～12个月，Engel评分：1级6例，2级14例，3级12例，4级4例。结论改良小骨窗胼胝体切开术具有创伤小、愈合快、术后并发症少等优点，值得临床进一步推广。Objective To summarize the effectiveness of improved surgical techniques of corpus callosotomy in patients with refractory epilepsy. Methods A retrospective analysis was performed on the clinical data of 36 patients with refractory epilepsy, admitted to our hospital from July 2003 to July 2010; the incision via improved small bone window was summarized on skin incision, bone flap design, surgical advantages and disadvantages, and intraoperative precautions. Results A S-shaped or an approximately U-shaped incision was made in the right frontal scalp. The craniotomy was performed with a small trapezoid bone window （the topline, the baseline and the height： 2, 4 and 2.5 cm, respectively）. With the help of microscope, the extent of sectioning consisted of the anterior 2/3 of the total length of the corpus callosum. Post-surgical outcome was assessed according to Engel＇ s scale scores for 9 to 12 months of follow-up： 6 patients were in grade I, 14 in grade II, 12 in grade III and 4 in grade IV. Conclusion Improved corpus callosotomy has such advantages as little damage to the tissues, few complications and quick recovery, indicating that it is worth for further generalization.

关 键 词：胼胝体切开术 难治性癫痫 小骨窗 

分 类 号：R742.1[医药卫生—神经病学与精神病学]