脑多发海绵状血管畸形并发癫痫手术治疗15例临床分析  

Surgical treatment of multiple cerebral cavernous malformations combined with epilepsy in 15 cases

作　　者：张文君[1] 吴红记[2] 张磊[2] 李树文[2] 邸辉[3] Zhang Wenjun, Wu Hongji, Zhang Lei, Li Shuwen, Di Hui(1Department of Radiology, East Hospital of the First Central Hospital of Baoding, Baoding 071000, China;2Department of Neurosurgery, the First Central Hospital of Baoding, Baoding 071000,China;3Department of Neurosurgery, Affiliated Hospital of Hebei University,Baoding 071000, Chin)

机构地区：[1]河北省保定市第一中心医院东院放射科,071000 [2]河北省保定市第一中心医院,071000 [3]河北大学附属医院神经外科,保定071000

出　　处：《中国实用医刊》2018年第3期20-21,共2页Chinese Journal of Practical Medicine

基　　金：河北省保定市科学技术研究与发展指导计划（17ZF075）

摘　　要：目的 探讨原发性高血压患者的不同血压参数与原发性高血压患者冠状动脉病变的相关性.方法 选取确诊为原发性高血压且行冠状动脉造影检查患者103例,其中至少1支主要分支狭窄≥50％者55例,为冠心痛组;冠状动脉正常者48例,为对照组.于相同条件下行动脉功能检查测定两组无创中心动脉压及24h动态血压监测.结果 两组患者夜间外周收缩压均值、全天外周脉压、无创中心动脉收缩压（CSAP）、无创中心动脉脉压（CPP）、夜间血压（收缩压及舒张压）均值下降率（MBPF）、无创中心动脉收缩压分数（CFSP）、无创中心动脉舒张压分数（CFDP）、无创中心脉压指数（CPPI）比较差异均有统计学意义（P均＜0.05）,经Logistic逐步回归分析得出,无创CPP、CPPI、CFSP升高及CFDP下降是冠心病的危险因素（P＜0.05）.结论 无创CPP、CPPI、CFSP升高及CFDP下降是冠状动脉病变的危险因素,可作为高血压患者冠状动脉病变程度早期预测的敏感指标.Objective To summarize the surgical treatment effect on patients who suffered from multiple cerebral cavernous malformations and epilepsy.Methods The data of 15 patients who underwent operation for multiple cerebral cavernou malformations and epilepsy were retrospectively analyzed.Results After operation,13 patients had no seizures from operation finished to follow-up and 2 patients experienced epilepsy recurrence after operation.One patient appeared the muscle force of contralateral limbs decreasing after the resection of cavernous malformation in the frontal lobe,and then was gradually rehabilitated after treatment.No patient died after the operation.During the follow-up period of 27.5 months on average （6-66 months）,no patient had a recurrence of cavernous malformations.Conclusions Patients with cerebral multiple cavernous malformations are prone to be complicated by epilepsy.According to the location of the cavernous malformation and intraoperative electrophysiological monitoring,we can effectively treat the multiple cerebral cavernous malformations complicated by epilepsy by individualized epileptogenic lesion resection,cortical thermal ablation and enlarged resection of the hippocampus amygdala.

关 键 词：海绵状血管畸形 癫痫 显微手术 

分 类 号：R651.1[医药卫生—外科学]