迷走神经刺激术治疗难治性癫痫的疗效和安全性  

Efficacy and safety of vagus nerve stimulation in the treatment of refractory epilepsy

作　　者：杨转移[1] 刘定阳[1] 杨治权[1] 陈晓宇[1] 蔡宇祥 刘涧 张俊美[1] 李苏珊 YANG Zhuanyi;LIU Dingyang;YANG Zhiquan;CHEN Xiaoyu;CAI Yuxiang;LIU Jian;ZHANG Junmei;LI Sushan(Department of Neurosurgery,Xiangya Hospital,Central South University,Changsha 410008,China)

机构地区：[1]中南大学湘雅医院神经外科,长沙410008

出　　处：《中南大学学报（医学版）》2021年第10期1096-1101,共6页Journal of Central South University ：Medical Science

基　　金：国家重点研发计划(2016YFC0105901XYY)。

摘　　要：目的:迷走神经刺激术是一种治疗难治性癫痫的神经调控方法,适用于不能切除癫痫病灶或者病灶切除手术失败的难治性癫痫患者。本研究探讨迷走神经刺激术治疗难治性癫痫的疗效和安全性,并分析影响疗效的因素。方法:回顾性分析2016年4月至2019年8月在中南大学湘雅医院行迷走神经刺激术的35例难治性癫痫患者的临床及随访资料。结果:术后随访6~47(平均26个月),MuHugh分级Ⅰ级7例,Ⅱ级13例,Ⅲ级8例,Ⅳ~Ⅴ级7例。病程短的患者手术效果好于病程长者(分别为77.8%和50.0%,P=0.013),而不同年龄(P=0.382)、性别(P=0.824)、发作类型(P=0.829)和MRI表现(P=0.791)的患者疗效差异无统计学意义。所有患者无永久不良反应发生。结论:迷走神经刺激术是一种安全、有效的治疗难治性癫痫的辅助方法,病程短的患者疗效好。Objective: Vagus nerve stimulation(VNS) is a neuromodulative therapeutic technique for patients with drug-resistant epilepsy who are not suitable for resection or who have experienced a failed resection. This study aims to explore the efficacy and safety of VNS in patients with refractory epilepsy, and to analyze the influential factors for the efficacy.Methods: A retrospective review of clinical data were conducted for 35 patients, who were treated for refractory epilepsy through VNS surgery in the Department of Neurosurgery,Xiangya Hospital, Central South University from April 2016 to August 2019. All patients were analyzed in terms of the clinical and follow-up data.Results: After a mean follow-up of 26 months(6-47 months), outcome was as follows: 7 patients were Mu Hugh class Ⅰ, 13 patients were Mu Hugh class Ⅱ, 8 patients were Mu Hugh class Ⅲ, and 7 patients were Mu Hugh class Ⅳ-Ⅴ. The total efficacy rate in the short duration group was significantly higher than that in the long duration group(77.8% vs 50.0%, P=0.013), whereas different ages(P=0.382), gender(P=0.824), types of seizure(P=0.829), and MRI features(P=0.791) showed no correlation with efficacy. None patients developed permanent complication postoperatively.Conclusion: VNS is a safe and effective option in treating patients with refractory epilepsy,especially for those with short duration.

关 键 词：迷走神经刺激术 难治性癫痫 MuHugh分级 

分 类 号：R742.1[医药卫生—神经病学与精神病学]