致痫性节细胞胶质瘤手术治疗对癫痫预后影响因素分析  

Analysis of Prognostic Factors Contributing to Seizure Outcomes of Epileptogenic Ganglioglioma Surgery

作　　者：吕文 胡继良 王浩[1] 陈佳 黄志清[2] 

机构地区：[1]深圳市人民医院神经外科,广东深圳518020 [2]深圳市南山区人民医院神经外科,广东深圳518052

出　　处：《临床误诊误治》2015年第11期68-70,共3页Clinical Misdiagnosis & Mistherapy

基　　金：深圳市科技计划项目(201302196)

摘　　要：目的探讨手术治疗节细胞胶质瘤所致癫痫预后的影响因素。方法回顾性分析采用手术治疗的致痫性节细胞胶质瘤11例的临床资料,对节细胞胶质瘤所致癫痫预后的影响因素进行分析。结果本组病灶位于颞叶8例,颞叶外3例;术前癫痫病程平均4.5年;癫痫复杂部分性发作6例,单纯部分性发作5例,其中继发全面强直发作3例;肿瘤完全切除9例,不完全切除2例。术后平均随访26.3个月,癫痫预后:Engel I级7例(63.6%),Ⅱ级3例(27.3%),Ⅲ级1例(9.1%)。统计学分析结果显示,MRI表现肿瘤钙化、强化、囊性变,肿瘤是否位于颞叶,肿瘤全切以及癫痫发作形式与癫痫预后无关(P>0.05);但术前继发全面强直发作及癫痫病程明显影响癫痫预后(P<0.05)。结论致痫性节细胞胶质瘤早期手术可较好地控制癫痫发作症状,单纯病灶切除即可达到良好效果,术前继发全面强直发作提示预后不良。Objective To analyze the prognostic factors contributing to seizure outcomes of epileptogenic ganglioglio-ma surgery. Methods The clinical data of 11 patients with ganglioglioma after operation were retrospectively studied and the prognostic factors contributing to seizure outcomes of epileptogenic ganglioglioma surgery were analyzed. Results In our re-search, 8 cases were located in the temporal lobe, 3 cases were in extra temporal lobe. The mean seizure duration prior to sur-gery was 4. 5 years. Six patients had complex partial seizures, five patients had simple partial seizures, and secondary general-ization occurred in three patients. Gross total resection was achieved in nine patients while subtotal resection in two patients. The average follow up periods were 26. 3 months. Seven patients were Engel Class I （63. 6%）, three patients were Engel classⅡ （27. 3%） and one patient was classⅢ （9. 1%）. The MRI findings showed tumor calcification, enrichment, cystic degeneration, the tumor in the temporal lobe or not, and extent of tumor resection, and seizure type were not correlated with postoperative seizure outcome （P〉0. 05）, the duration prior to surgery and secondary generalization proved to be significantly correlated with the seizure outcome （ P〈0. 05 ） . Conclusion Early surgical intervention is necessary for achieving earlier and better seizure control. Simple lesion ectomy is sufficient for favorable postoperative seizure outcome. Secondary generalized tonic seizure is a bad predictor for postoperative seizure outcome.

关 键 词：神经胶质瘤 外科手术 癫痫 预后 

分 类 号：R730.264[医药卫生—肿瘤] R742.1[医药卫生—临床医学]