前颞叶切除术与选择性杏仁核海马切除术治疗颞叶癫痫的疗效对比  

Effect of anterior temporal lobectomy versus selective amygdalohippocampectomy for temporal lobe epilepsy

作　　者：李亚飞 尹绍雅[2] LI Yafei;YIN Shaoya(Graduate School of Tianjin Medical University,Tianjin 300070,China;Tianjin Huanhu Hospital,Tianjin 300350,China)

机构地区：[1]天津医科大学研究生院,天津300070 [2]天津市环湖医院,天津300350

出　　处：《中国实用神经疾病杂志》2020年第12期1036-1040,共5页Chinese Journal of Practical Nervous Diseases

基　　金：天津市卫计委科技攻关项目(编号:2014KG116)。

摘　　要：目的对比前颞叶切除术与选择性杏仁核海马切除术治疗颞叶癫痫发作的效果。方法回顾性分析天津市环湖医院神经外科2010-12—2016-08手术治疗的颞叶癫痫病例38例,其中14例进行前颞叶切除术,9例进行选择性杏仁核海马切除术,术后随访2~8 a,分析纳入的23例患者的基本信息、手术侧别、发作症状、病理学以及术后癫痫发作的Engel分级。结果在随访的23例患者中,达到满意控制(EngelⅠ~Ⅱ级)者18例(78.3%),其中前颞叶切除术组达到满意控制(EngelⅠ~Ⅱ级)者12例(85.7%),选择性杏仁核海马切除术组达到满意控制(EngelⅠ~Ⅱ级)者6例(66.7%)。经Fisher确切概率法检验,2组术后控制率差异无统计学意义(P>0.05)。结论手术是治疗颞叶癫痫安全有效的方法,两种手术均可获得满意的临床效果。Objective To compare the effects of anterior temporal lobotomy and selective amygdalohippocampectomy in the treatment of temporal lobe seizures,in order to provide some references for the selection of surgical methods in the future.Methods 38 cases of temporal lobe epilepsy treated surgically in the department of neurosurgery,Tianjin Huanhu Hospital from December 2010 to August 2016 were retrospectively analyzed.Among them,14 patients underwent anterior temporal lobular resection and 9 underwent selective amygdalohippocampectomy.The 23 patients were followed up for 2-8 years to analyze the basic information,operative profile,seizure symptoms,pathology,and Engel grading of postoperative epileptic seizures.Results In follow-up of 23 cases of patients,to achieve satisfactory control(EngelⅠ-Ⅱlevel)of 18 cases(78.3%),induding anterior temporal lobotomy group to achieve satisfactory control(EngelⅠ-Ⅱlevel)12 cases(85.7%),selective amygdalohi-ppocampectomy group to achieve satisfactory control(EngelⅠ-Ⅱlevel)6 cases(66.7%).After Fisher's exact probability test,P>0.05.Conclusion Surgery is a safe and effective method for the treatment of temporal lobe epilepsy,and both of which can achieve satisfactory clinical results.

关 键 词：颞叶癫痫 前颞叶切除术 选择性杏仁核海马切除术 癫痫发作 神经心理功能 

分 类 号：R742.1[医药卫生—神经病学与精神病学]