微创锁孔入路选择性海马杏仁核切除治疗伴海马硬化的内侧颞叶癫痫  

Treatment of intractable temporal lobe epilepsy with hippocampal sclerosis by using selective amygdalohippocampectomy with keyhole approach

作　　者：刘翔宇[1] 孙康健[1] 王汉东[1] 王娟[1] 杨昉[2] 张志强[3] 李杰[1] LIU Xiang-yu SUN Kang-jian WANG Han-dong et al(Department of Neurosurgery , Nanjing Jinling Hospital, Nanjing 210002, China Corresponding author：WANG Han-dong)

机构地区：[1]南京军区南京总医院神经外科,南京210002 [2]南京军区南京总医院神经内科,南京210002 [3]南京军区南京总医院影像科,南京210002

出　　处：《临床神经外科杂志》2017年第1期9-12,16,共5页Journal of Clinical Neurosurgery

基　　金：江苏省医学重点学科基金资助项目(X4200722);南京军区医药卫生科研基金(14ZX16);南京市科技计划项目(201605078)

摘　　要：目的探讨经颞上沟-侧脑室锁孔入路选择性海马杏仁核切除术治疗难治性内侧颞叶癫痫的疗效及安全性。方法回顾性分析2014年9月~2016年3月南京军区南京总医院神经外科19例难治性内侧颞叶癫痫患者的临床资料。患者均采用颞上沟-侧脑室锁孔入路选择性海马杏仁核切除手术方式。结果术后复查头颅MRI示,手术切除范围满意。术后随访6~24个月,EngelⅠ级14例(73.6%)、Ⅱ级4例(21%)、Ⅲ级1例(5.4%),无严重手术并发症。结论经颞上沟-侧脑室锁孔入路选择性海马杏仁核切除术治疗难治性内侧颞叶癫痫安全有效;与传统手术入路相比,手术创伤小,手术时间缩短。Objective To explore the value of selective amygdalohippocampectomy with keyhole approach for the treatment of intractable temporal lobe epilepsy with hippocampal sclerosis. Methods A retrospective study was conducted to evaluate the safety and validityof keyhole selective amygdalohippocampectomy for refractory mesial temporal lobe epilepsy（ MTLE） by analyzing clinical data of 19 patients who received the surgical procedure between September 2014 to March 2016. Results All patients were followed up for 6- 24 months. 14 patients attain seizure free（ EngelⅠ,73. 6%）,4 patients with rare disabling seizures（ Engel Ⅱ,21%） and 1 patient with worthwhile seizure reduction（ Engel Ⅲ,5. 4%）. Conclusion Selective amygdalohippocampecto-my with keyhole approach is a safe and feasible surgical procedure to treat refractory mesial temporal epilepsy with hippocampal sclerosis. Compared with the conventional approach,this technique can make the operation easier and less traumatic.

关 键 词：颞叶癫痫 锁孔入路 海马-杏仁核切除术 海马硬化 

分 类 号：R742.1[医药卫生—神经病学与精神病学]