婴幼儿难治性癫痫的手术治疗效果分析  

Surgical outcomes of infants with intractable epilepsy

作　　者：夏桂枝[1] 任榕娜[1] 杨勇辉[1] 梅珍[2] 杨朋范[2] 

机构地区：[1]南京军区福州总医院(福建医科大学福总临床医学院)儿科,福建福州350025 [2]南京军区福州总医院(福建医科大学福总临床医学院)神经外科癫痫中心,福建福州350025

出　　处：《东南国防医药》2015年第4期378-379,411,共3页Military Medical Journal of Southeast China

摘　　要：目的：探讨婴幼儿难治性癫痫的手术治疗效果、安全性及致痫灶病理类型。方法2010年1月－2014年6月某院神经外科癫痫中心进行手术治疗并随访至少6个月的11例9个月～2岁10个月婴幼儿难治性癫痫病例，采用Engel分级分析术后癫痫控制情况，观察术后并发症发生情况，并分析手术切除的致痫灶的病理类型。结果术后Engel分级：8例Ⅰ级，1例Ⅱ级，2例Ⅲ级；所有病例术后均未见严重并发症发生；病理类型及相对应手术治疗效果：节细胞胶质瘤1例，海绵状血管瘤1例，胚胎发育不良性神经上皮性肿瘤1例，海马硬化2例，手术治疗效果均达到EngelⅠ级；局灶性皮质发育不良4例，手术效果2例达到EngelⅠ级，1例EngelⅡ级，1例Engel Ⅲ级；2例行胼胝体切开术，手术效果1例达到EngelⅠ级，1例达到EngelⅢ级。结论在充分的术前评估的基础上，对婴幼儿难治性癫痫进行手术治疗具有较好的治疗效果和安全性，致痫灶病理类型与手术治疗效果密切相关。Objective To explore the efficacy and safety of surgery for infants with intractable epilepsy, analyze the patholog-ical features of epileptogenic foci.Methods The outcomes of 11 intractable epilepsy patients （ aged 9-34 month） that underwent surgery were collected between January 2010 to June 2014.All patients were followed up for at least 6 months after surgery.The effica-cy of surgery was evaluated with Engel class, the complications of surgery and pathological features of epileptogenic foci were observed after surgery.Results Postoperative Engel classes wereⅠ,Ⅱ, andⅢin 8 patients, 1 patient, and 2 patients, respectively.No pa-tient suffered from severe complications.The major pathological findings in these patients included：ganglioglioma in 1 case, cavernous angioma in 1 case, dysembryoplastic neuroepithelial tumor in 1 case, hippocampal sclerosis in 2 case, these 5 patients achieved Engel class Ⅰoutcomes.Focal cortical dysplasia in 4 cases, 2 patients achieved Engel classⅠoutcomes, 1 patient achieved Engel Ⅱout-come, 1 patient achieved Engel classⅢoutcome.Corpus callosotomy was conducted in 2 patients, 1 patient achieved Engel classⅠoutcome, 1 patient achieved Engel class Ⅲoutcome.Conclusion Surgery for infant with intractable epilepsy was effective and safe basing on the sufficient evaluation before surgery.There was a close contact between the efficacy of surgery and pathological type.

关 键 词：婴幼儿 难治性癫痫 手术 

分 类 号：R742.1[医药卫生—神经病学与精神病学]