标准前颞叶联合海马、杏仁核切除对低级别胶质瘤合并癫痫患者预后的影响  

Effects of standard anterior temporal lobectomy combined with selective amygdalohippocampectomy on the prognosis of patients with low-grade glioma and epilepsy

作　　者：杨继学 王向辉 李东明 王迎兵 董燕[1] 王海艳[1] YANG Ji-xue;WANG Xiang-hui;LI Dong-ming;WANG Ying-bing;DONG Yan;WANG Hai-yan(Department of Neurosurgery,the Third Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,Henan,CHINA)

机构地区：[1]郑州大学第三附属医院神经外科,河南郑州450052

出　　处：《海南医学》2022年第13期1681-1685,共5页Hainan Medical Journal

基　　金：河南省医学科技攻关计划联合共建项目(编号:LHGJ20190373)。

摘　　要：目的 探讨标准前颞叶切除术(SATL)联合选择性杏仁核、海马切除术(SelAH)对低级别胶质瘤(LGG合并癫痫患者预后的影响。方法 选取2016年7月至2020年7月在郑州大学第三附属医院诊治的93例LGG合并癫痫患者,根据不同手术方式分为观察组(48例)和对照组(45例),观察组为SATL联合SelAH,对照组为SATL。比较两组术后早期癫痫发作情况,近远期并发症,日常生活能力(ADL)评分及术后12个月Engel分级的差异。结果 观察组近期并发症发生率为29.17%,与对照组的42.22%比较差异无统计学意义(P>0.05),但观察组早期癫痫发作发生率为8.33%,明显低于对照组的28.89%,差异有统计学意义(P<0.05);观察组远期并发症发生率为12.50%,与对照组的17.78%比较差异无统计学意义(P>0.05);术后6个月、12个月,观察组ADL评分分别为(70.02±4.33)分、(88.15±9.12)分,明显高于对照组的(60.47±3.69)分、(70.27±8.14)分,差异均有统计学意义(P<0.05);观察组术后12个月Engel分级情况优于对照组,且Ⅰ级例数占比75.00%,明显高于对照组的53.33%,差异有统计学意义(P<0.05)。结论 SATL联合SelAH可有效控制早期、远期癫痫发作,且不会增加更多术后近、远期并发症,改善患者预后。Objective To explore the effects of standard anterior temporal lobectomy(SATL) combined with selective amygdalohippocampectomy(SelAH) on the prognosis of children with low-grade glioma(LGG) and epilepsy.Methods A total of 93 patients with LGG complicated with epilepsy treated in the Third Affiliated Hospital of Zhengzhou University from July 2016 to July 2020 were selected. According to different surgical methods, they were divided into an observation group(48 cases) and a control group(45 cases). The observation group was treated with SATL combined with SelAH, while the control group was treated with SATL. The differences of early postoperative seizures,short-term and long-term complications, Activities of Daily Living(ADL) score, and Engel grade 12 months after operation were compared between the two groups. Results The difference in incidence of short-term complications between observation group and control group was not statistically significant(29.17% vs 42.22%, P>0.05). The incidence of early epilepsy in the observation group was significantly lower than that in the control group(8.33% vs 28.89%), and the difference was statistically significant(P<0.05). The difference in incidence of long-term complications between the two groups was not statistically significant(12.50% vs 17.78%, P>0.05). At 6 and 12 months after surgery, ADL scores in observation group were(70.02±4.33) points and(88.15±9.12) points, significantly higher than(60.47±3.69) points,(70.27±8.14)points in the control group, and the difference was statistically significant(P<0.05). Engel grading in the observation group was better than that in control group at 12 months after surgery, and proportion of cases at grade Ⅰ was significantly higher than that in control group(75.00% vs 53.33%), with statistically significant difference(P<0.05). Conclusion SATL combined with Sel AH can effectively control early and long-term epilepsy, which can improve the prognosis of patients and does not increase the short-term and long-term postoperative comp

关 键 词：低级别胶质瘤 癫痫 标准前颞叶切除术 选择性海马、杏仁核切除术 预后 

分 类 号：R739.4[医药卫生—肿瘤]