胶质瘤相关性癫痫术后疗效及影响因素分析  

Analysis of postoperative efficacy and the influencing factors of the recurrence of epilepsy in Glioma-related Epilepsy

作　　者：杨卓[1] 王新军[1] 杨如意[1] 

机构地区：[1]郑州大学第五附属医院神经外科,郑州450052

出　　处：《中国神经精神疾病杂志》2017年第4期220-224,共5页Chinese Journal of Nervous and Mental Diseases

基　　金：河南省教育厅科学技术研究重点项目(编号:14A320078);郑州市科技发展计划项目(编号:20150390)

摘　　要：目的探讨胶质瘤相关性癫痫患者术后恢复情况,以及痫性再次发作的危险因素。方法收集89例胶质瘤相关性癫痫患者的一般资料。所有患者行肿瘤及致痫灶切除术,记录患者术后1周,术后1个月,术后3个月,术后6个月的Engle分级评分,其差别行组内重复测量资料的方差分析,应用Kaplan—Meier法制作痫性再发风险曲线,并对癫痫再次发作相关因素行Cox回归模型分析。结果术后癫痫再发率为26.97%(24/89),术后1周Engle分级评分为2.966±0.081,术后1月为2.202±0.080,术后3月为1.730±0.093,术后6月为1.313±0.042,差异存在统计学意义(F_(时间)=96.076,P<0.01);Cox回归模型显示,肿瘤累及部位(RR=2.908,CI:1.083~7.806),术后水肿形成(RR=4.769,CI:1.737~13.096)以及肿瘤复发(RR=8.309,CI:3.379~20.432)是癫痫再次发作的重要危险因素(均P<0.05)。结论术后患者的癫痫发作减少甚至消除,长期疗效优于短期疗效,对癫痫再次发作相关因素应尽早处理,有利于提高患者预后的生存质量。Objective To explore the postoperative recovery of the patients with glioma-related epilepsy and the possible risk factors for recurrence of epilepsy. Methods To collect clinical data of 89 patients with glioma- related epilepsy, we recorded Engle grade score of all patients underwent resection of tumor and seizure focus in a week, 1,3 and 6 month after surgery Repeated measures ANOVA was used to analysis the difference within group. Kaplan-Meier method and Cox regression analysis were used to analysis seizure recurrence risk curve and the epileptic recurrence related factors, respectively. Results The postoperative recurrence rate was 26.97% （24/89）. Engle grade scores were 2.966＋0.081. 2.202＋0.080, 1.730＋0.093 and 1.313-＋0.042 in a week, 1,3 and 6 month after surgery. The difference was statistically significant （F~,~=96.076,P=0.000）. Cox regression model showed that tumor accumulation site （RR =2.908, CI： 1.083 -7.806 ）, postoperative edema formation （RR =4.769, CI： 1.737 - 13.096 ）, tumor relapse （RR=8.309,Cl：3.379-20.432）were the important risk factors for recmTence epileptic seizures （all P〈 0.05）. Conclusions Surgical treatment can significantly reduce or even eliminate seizures postoperative and its long term efficacy is superior to short term efficacy. Appropriate measures should be taken to treat risk factors associated with recurrence epileptiform seizure to improve the prognosis of patients quality of life.

关 键 词：胶质瘤相关性癫痫 Engle分级评分 癫痫再次发作 危险因素 

分 类 号：R739.41[医药卫生—肿瘤]