局灶性皮质发育不良致药物难治性癫痫的手术预后及其影响因素  

Analysis of factors related to postoperative prognoses in focal cortical dysplasia patients with refractory epilepsy

作　　者：王逸鹤[1] 赵国光[1] 单永治[1] 樊晓彤[1] 安阳[1] 卢超[1] WANG Yi-he;ZHAO Guo-guang;SHAN Yong-zhi;FAN Xiao-tong;AN Yang;LU Chao(Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing 100053, China)

机构地区：[1]首都医科大学宣武医院神经外科,北京100053

出　　处：《中国临床神经外科杂志》2017年第11期737-740,共4页Chinese Journal of Clinical Neurosurgery

基　　金：北京市科委市民健康培育项目(Z141100002114034)

摘　　要：目的探讨局灶性皮质发育不良(FCD)导致的药物难治性癫痫的手术预后及其影响因素。方法回顾性分析2007年5月至2015年11月手术治疗的97例病理确诊为FCD导致的药物难治性癫痫的临床资料。结果手术全切致痫灶71例,未全切26例。术后出现颅内感染5例、脑积水2例。1例术后第三年死亡。术后平均随访(59.18±28.62)个月。术后病理:FCDⅠ、Ⅱ、Ⅲ型分别为38、23、36例。术后EngelⅠ级60例,Ⅱ级11例,Ⅲ级16例,Ⅳ级10例。多因素Cox比例风险回归模型分析结果显示,MRI有阳性发现、致痫灶全切的病人预后好。K-M生存分析显示5年预后良好的概率为59%左右。结论对于FCD致药物难治性癫痫,MRI有阳性发现、手术年龄<18岁及全切致痫灶的病人手术预后良好。Objective To analyze the surgical outcomes and factors related to postoperative prognoses in focal cortical dysplasia(FCD)patients with refractory epilepsy.Methods The clinical data the97FCD patients with refractory epilepsy treated in Department of Neurosurgery,Xuanwu Hospital,Capital Medical University from May,2007to November,2015were analyzed retrospectively.Results The mean follow-up time in these97patients was(59.18±28.62)months.The epilepsy control reached Engel grade I in60patients,gradeⅡin11,gradeⅢin16and gradeⅣin10.The prognoses of postoperative FCD patients with refractory epilepsy were related to MRI results(positive or negative)and the resection extent of epileptogenic zone.Conclusion The present results show that the effects of surgery on the refractory epilepsy in the patients with FCD are good.MRI positive results and total resection of epileptogenic zone are the favorable prognosis factors in FCD patients with refractory epilepsy.

关 键 词：药物难治性癫痫 局灶性皮质发育不良 手术 预后 影响因素 

分 类 号：R742.1[医药卫生—神经病学与精神病学] R651.11[医药卫生—临床医学]