234例颞叶癫痫患者临床资料分析  

Clinial data analysis of 234 patients with intractable temporal lobe epilepsy

作　　者：李萌[1] 余胜坤[1] 浦松[1] 刘利[1] 林志国[1] 沈红[1] 

机构地区：[1]哈尔滨医科大学附属第一医院神经外科,哈尔滨150001

出　　处：《中华神经医学杂志》2014年第3期288-291,共4页Chinese Journal of Neuromedicine

基　　金：黑龙江省国际合作项目（WB10810401）

摘　　要：目的通过回顾性分析颞叶癫痫大宗病例临床资料，为提高难治性颞叶癫痫手术疗效提供参考。方法选择哈尔滨医科大学第一附属医院自2000年1月至2010年12月收治的颞叶癫痫患者234例，所有患者资料完整并且随访时间达6个月以上。系统分析患者的神经电生理、影像学检查结果及组织病理学等临床资料，对比分析术后不同时间点不同类型患者疗效的差异。结果神经电生理结果显示，234例患者单侧放电167例，双侧放电67例。其中双侧放电患者中．一侧优势患者38例，双侧均等患者29例。术后第2年234例患者Engel1分级评定结果显示．单侧放电患者疗效优于任一类型双侧放电患者，差异有统计学意义（P，0．05）。影像学结果显示，不同病因造成的颞叶癫痫患者中，海马硬化患者达97例（41．5％），在所有患者中比例最高且疗效最好，术后第2年EngelI级患者达到82例（占该病因患者总数的84．5％1。结论单侧局灶性病变的患者及海马硬化导致的癫痫患者手术效果相对较好。Objective To provide data for improving the treatment effect on intractable temporal lobe epilepsy by retrospectively analyzing the clinical data of a large number of patients. Methods Two hundred and thirty-five patients with intractable temporal lobe epilepsy, admitted to our hospital from January 2000 to December 2010, were chosen in our study; these patients had a follow up for over 6 months; their clinical data, including neural electrophysiology, imaging and histopathology, were retrospectively analyzed to compare the treatment efficacy of different types of patients at different time points of treatment. Results Neural electrophysiology showed unilateral epileptiform discharges in 167 patients, bilateral epileptiform discharges in 67 patients; further study showed that lateral dominance was noted in 38 and bilateral equalization in 29 patients of the 67 patients with bilateral epileptiform discharges. In the second year of operation, based on the Engel standard, patients with unilateral epileptiform discharges had significantly better effect than those with bilateral epileptiform discharges （P〈0.05）. Imaging showed that hippocampal sclerosis had the highest percentage （41.5%, 97/234）, with highest postoperative satisfaction rate （Engel I was noted in 82 patients）. Conclusion Patients with unilateral focal lesions and patients with hippocampal sclerosis have good surgical results.

关 键 词：颞叶癫痫 手术治疗 回顾性研究 

分 类 号：R742.1[医药卫生—神经病学与精神病学]