机器人无框架立体定向仪在顽固性癫痫定位和治疗方面的应用  

To locate the epileptic onset zone and treat the intractable epilepsyby robot assistant frameless system

作　　者：吴朝晖[1] 田增民[1] 赵全军[1] 张剑宁[1] 肖霞[1] 王红[1] 林鸿[1] 王福莉[1] 

机构地区：[1]海军总医院神经外科,北京100048

出　　处：《转化医学杂志》2013年第1期30-34,共5页Translational Medicine Journal

摘　　要：目的探讨机器人辅助无框架立体定向系统置入深部电极和射频热凝毁损的方法及效果。方法对7例额、颞发作间期存在痫样放电的顽固性癫痫患者,采用机器人辅助无框架立体定向系统经额向双侧颞叶内侧置入深部电极,记录深部电极脑电图。深部电极脑电图记录到颞叶内侧为临床发作或电发作起源灶者,遂行机器人立体定向系统经额入路射频热凝颞叶深部结构;并对6例同意进行神经干细胞移植者移植干细胞。结果术后24～52个月,7例随访按照Engel分级系统Ⅰ级4例(其中Ⅰa级3例、Ⅰd级1例),Ⅳa级2例、Ⅳc级1例。未有术后神经功能明显下降。结论机器人辅助立体定向系统置入深部电极、射频热凝毁损和移植神经干细胞安全、有效、方便、快捷,部分额、颞叶顽固性癫痫患者对立体定向射频热凝和神经干细胞移植治疗反应良好。Objective To investigate the technology of depth electrodes implantation and radio- frequency thermocoagulation to treat epilepsy by robot assistant frameless stereotaxy. Methods Depth electrode implatations were performed by robot assistant frameless system in 7 patients with temporal and/or frontal interictal epileptiform discharges. Because the mesial temporal was the onset zone of electrographic or clinical seizure, all of the 7 patients accepted transfrontal mesial temporal lobe radiofrequency thermocoagulation by robot assistant frameless system, and 6 out of 7 patients accepted neural stem cells transplantation. Results The postoperative outcomes were evaluted according to Engel classification ：4 patients achieved Engel class Ⅰ （including 3 Ⅰ a） ,2 Engel class Ⅳ a, and 1 Engel Ⅳ c. It indicated no obvious reduction of nerve function after surgery. Conclusion The depth electrode implantation,radiofrequency thermocoagulation and neural stem cells transplantation by robot assistant frameless stereotaxy were safe, effective, convenient, and swift. Some patients with intractable epilepsy could be cured by radiofrequency thermocoagulation and neural stem cells transplatation.

关 键 词：顽固性癫痫 深部电极脑电图 射频热凝 立体定向技术 无框架 机器人 

分 类 号：R742.1[医药卫生—神经病学与精神病学]