颅内节细胞胶质瘤所致癫痫的手术预后相关因素分析  

Analysis of factors related to prognoses in patients with epilepsy due to intracranial gangliogliomas undergoing surgery(report of 51 cases)

作　　者：刘长青[1] 陈凯[1] 于思科 关宇光[1] 周健[1] 栾国明[1] 

机构地区：[1]首都医科大学北京三博脑科医院功能神经外科,100093

出　　处：《中国临床神经外科杂志》2014年第5期260-262,共3页Chinese Journal of Clinical Neurosurgery

基　　金：十二五科技部国家科技支撑计划(2012BAI03B02);首都临床特色应用研究(Z13110700220000);国家临床重点专科(SG2011-02-1-3)

摘　　要：目的探讨颅内节细胞胶质瘤（GG）所致癫痫患者的手术预后相关因素。方法回顾性分析我院2008年4月至2012年12月收治的5l例GG所致癫痫患者的临床资料。结果51例患者中68．6％（35／51）为药物难治性癫痫，72．5％（37／51）的患者肿瘤位于颞叶；70．6％（36／51）行肿瘤全切，29．4％（15／51）行次全切除。74．5％（38／51）患者合并局灶性皮质发育不良（FCD）。随访1。5年，84．3％（43／51）的患者癫痫达到EngelI级。肿瘤全切患者的癫痫缓解（EngelI级）率为94．4％（34／36），次全切的缓解率为60．0％，二者差异显著（P〈0．05）。结论GG通常为低级别肿瘤，手术全切除患者癫痫控制率较高；GG常合并FCD，为了取得更好的癫痫控制率，手术不仅要切除GG，也应将周围FCD切除。Objective To explore the factors related to the prognoses in the patients with epilepsy induced by intracranial ganglioglioma undergoing surgery. Methods The clinical data of 51 patents with epilepsy due to intracranial gangliogioma, who underwent surgery in Beijing Sanbo Brain Hospital from April, 2008 to December, 2012, were analyzed retrospectively, including clinical features, seizure history, surgical information, imaging data, electrophysiological data and following up information. Results Thirty-five patients （68.6%） suffered from intractable epilepsy. The gangliogliomas were in the temporal lobes in 37 patients （72.5%）. Of 51 patients, 36 （70.6%） underwent gross total resection of the tumors and 15 （29.4%） subtotal. Thirty-eight （74.5%） patients had a concomitant focal cortical dysplasia in pathology, and 14 （27.5%） had hippocampus sclerosis. There were no epileptic seizures （Engel class I ） in 43 （84.3%） patients 1 year after the surgery. The control rate [94,4% （34/36）] of epileptic seizures was significantly higher in the patients undergoing the total resection of the tumors than that [60% （9/15）] in the patients undergoing the subtotal resection of the tumors （P〈0.01）. Conclusion The curative effect of total resection of the lesions on epilepsy induced by the gangliongliomas is good.

关 键 词：节细胞胶质瘤 癫痫 显微手术 预后 影响因素 

分 类 号：R742.1[医药卫生—神经病学与精神病学] R651.11[医药卫生—临床医学]