胼胝体全段一期切开联合多种切除性手术治疗Lennox-Gastaut综合征（附九例报道）  

Single-stage total corpus callosotomy combined with different resective operations in children with Lennox-Gastaut syndrome

作　　者：马康平[1] 谭泊静[1] 易林华[1] 秦广彪[1] 杨玉成[2] 李云林[1] 

机构地区：[1]首都儿科研究所附属儿童医院神经外科,北京100020 [2]北京市海淀医院功能神经科,100080

出　　处：《中华神经医学杂志》2017年第12期1290-1293,共4页Chinese Journal of Neuromedicine

摘　　要：目的探讨胼胝体全段一期切开联合多种切除性手术治疗Lennox-Gastaut综合征（LGS）的临床效果。方法对北京市海淀医院功能神经科自2010年5月至2014年5月收治的9例LGS患儿，依据影像学、电生理检查及临床症状综合评估结果，均采用胼胝体全段一期切开联合多种切除性手术治疗，并对比分析其术前术后癫痫控制情况的差异。结果术后随访2年，9例患儿中EngelI级5例，EngelⅡ级3例，EngelⅢ级1例，手术有效率为88．9％（8／9）；9例患儿跌倒发作、痉挛发作、强直发作、强直阵挛发作频率等均有不同程度降低，其中以跌倒发作的治疗效果最好。3例患儿出现一过性缄默。术后1周内显著缓解，半年后完全恢复。结论对于内科治疗效果欠佳的LGS患儿，尽早行胼胝体全段一期切开联合多种切除性手术治疗，可以有效地控制癫痫发作。Objective To study the outcomes of Lennox-Gastaut syndrome （LGS） with single-stage total corpus callosotomy combined with different resective surgeries. Methods Nine LGS patients, admitted to our hospital from May 2010 to May 2014, were chosen in our study. Their clinical data were retrospectively analyzed. According to the results of anatomy, electrophysiology and clinical comprehensive evaluation, all the 9 children received single-stage total corpus callosotomy combined with different resective operations. The differences of epileptic seizures of these children before and after surgery were compared. Results The 9 LGS children were followed up for 2 years; 5 achieved Engel grade I, 3 achieved Engel grade II, and one achieved Engel grade III. The surgical effective rate was 88.9% （8/9）. The frequencies of drop seizures, convulsive seizures, tonic seizures and tonic-clonic seizures were decreased of different degrees, with drop seizures enjoying the best control. Three patients had transient silence, remarkable relief one week after surgery and total recovery half year after surgery. Conclusion Early single-stage total corpus callosotomy combined with different resective operations can help to control seizures in children with intractable LGS.

关 键 词：Lennox-Gastrdut综合征 胼胝体全段切开 癫痫 

分 类 号：R726.5[医药卫生—儿科]