药物难治性颞叶癫痫外科治疗后近期复发对患者长期疗效的影响  

The influence on the long-term effects of patients with recent recurrence after surgical treatment with drug refractory temporal lobe epilepsy

作　　者：刘继新[1] 依斯哈尔.巴拉提 王志丹[1] 迪里夏提.依马木 张宽[1] 李文娟[1] 李春丽[1] 熊志刚[1] 陈刚[2] 

机构地区：[1]新疆维吾尔自治区人民医院北院神经外科,乌鲁木齐830054 [2]新疆维吾尔自治区人民医院神经外科

出　　处：《中华临床医师杂志（电子版）》2015年第2期26-29,共4页Chinese Journal of Clinicians(Electronic Edition)

基　　金：国家自然科学基金(30960393)

摘　　要：目的研究药物难治性颞叶癫痫外科治疗后近期复发对患者长期效果的影响。方法选择2010年3月至2011年3月在我院神经外科接受手术治疗的患者64例,所有患者均由同一位医师执刀手术治疗。术后对所有患者进行随访,根据患者术后1年癫痫有无复发,将患者分为观察组(复发)和对照组(未复发),将两组患者术后的随访资料、术后远期(3年)疗效等进行分析对比。结果两组患者中,术后肿瘤性病变患者为8例(12.5%),混合性病变患者为11例(17.2%)、术后颞叶内侧硬化患者为28例(43.8%)、病理结果正常的患者为17例(26.5%)。手术后第3年,观察组的癫痫控制满意度为40.6%,对照组满意度为75.0%。观察组满意度明显低于对照组,差异具有统计学意义(P<0.05)。在多元Logistic回归分析结果中,复发次数大于3次、有复发诱因、复发时复杂部分性发作是影响TLE术后复发对远期疗效的独立影响因素。结论药物难治性颞叶外科手术治疗后近期复发对患者的远期疗效有影响,现已明确的影响因素包括有复发诱因、复发类型以及复发次数。Objective To study the influence on the long-term effect of patients with recent recurrence after surgery treatment with drug refractory temporal lobe epilepsy. Methods Sixty four patients who accepted surgical treatment in our hospital neurosurgery in March 2010 to March 2011 were involved in this study. All patients were performed by the same physician surgery treatment. Postoperative follow-up of all patients, according to the patients with postoperative relapse during 1 year, patients were divided into observation group （recurrence） and control group （without recurrence）, the effect postoperative follow-up data were analyzed, such as postoperative long-dated curative effect to two groups’ patients. Results There were 8 patients with postoperative tumor lesion （12.5%）, 11 patients with mixed lesions （17.2%）, 28 patients with postoperative with the medial temporal lobe （43.8%）, 17 patients with normal and pathological results （26.5%）. After 3 years surgery, observation group of epilepsy control degree of satisfaction was 40.6%, the control group was 75.0%. Satisfaction in observation group was obviously lower than the control group, the difference was statistically significant （P〈0.05）. In multivariate Logistic regression analysis results, recurrence times more than 3 times, have recrudescent inducement, recurrent complex partial seizures were independent risk factors of the recurrence of the effects of long-term curative effect after TLE. Conclusion Recent recurrence of drug refractory temporal lobe after surgical treatment effects prospective efficacy, and the definite influence factors include recurrent incentives, the types of recurrence and recurrence rate.

关 键 词：癫痫 颞叶 外科手术 

分 类 号：R742.1[医药卫生—神经病学与精神病学]