迷走神经刺激术治疗难治性癫痫的临床效果及对认知功能的影响  

Clinical effect of vagus nerve stimulation in the treatment of refractory epilepsy and its impact on cognitive function

作　　者：刘星 董长征[1] 周笋 康进生[1] 马万东 LIU Xing;DONG Chang-zheng;ZHOU Sun;KANG Jin-sheng;MA Wan-dong(The Second Department of Neurosurgery, Hebei General Hospital, Shijiazhuang 050051, China;School of Graduate, Hebei North University, Zhangjiakou 075000, China)

机构地区：[1]河北省人民医院神经外二科,河北石家庄050051 [2]河北北方学院研究生学院,河北张家口075000

出　　处：《河北医科大学学报》2022年第7期792-795,826,共5页Journal of Hebei Medical University

基　　金：河北省医学科学研究课题计划(20200732)。

摘　　要：目的探讨迷走神经刺激术治疗难治性癫痫的临床效果及对认知功能的影响。方法选取经迷走神经刺激术治疗的难治性癫痫患者12例,根据McHugh评级标准对术前1个月、术后第3、6、9、12个月评估治疗效果,瑞文推理测验评估智商,简单精神状态检查量表(mini-mental state examination,MMSE),蒙特利尔知识量表北京版(Montreal cognitive assessment,MoCA)评估认知功能水平。结果随治疗时间延长,发作频率逐渐减少,差异有统计学意义(P<0.05)。术后3个月发作缓解率大于50%以上占33.3%,术后6个月发作缓解率大于50%以上占66.7%,术后9个月发作缓解率大于50%以上占75.0%,术后12个月发作缓解率大于50%以上占83.33%。术后12个月智商、MMSE评分、MoCA北京版评分均高于术前1个月,差异有统计学意义(P<0.05)。结论迷走神经刺激术治疗难治性癫痫安全、有效,不仅可以降低患者癫痫发作频率,并且可以提高癫痫患者的智商水平及认知能力。Objective To investigate the clinical effect of vagus nerve stimulation in the treatment of refractory epilepsy and its impact on cognitive function.Methods A total of 12 patients with intractable epilepsy treated by vagus nerve stimulation were selected.According to the McHugh rating scale,the therapeutic effect was evaluated at 1 month before operation and at 3,6,9 and 12 months after operation.Raven′s reasoning test was used to evaluate IQ,and cognitive function was assessed by mini-mental state examination(MMSE),and the Beijing version of the Montreal cognitive assessment(MoCA).Results With the extension of treatment time,the frequency of attack gradually decreased,and the difference was statistically significant(P<0.05).The incidence of remission more than 50%was 33.3%in 3 months,66.7%in 6 months,75.0%in 9 months and 83.33%in 12 months.IQ,MMSE score and Beijing version of MoCA score at 12 months after surgery were higher than those at 1 month before surgery,and the differences were statistically significant(P<0.05).Conclusion Vagal nerve stimulation is safe and effective in the treatment of refractory epilepsy.It can not only reduce the frequency of epileptic seizures,but also improve the IQ level and cognitive ability of epileptic patients.

关 键 词：耐药性癫痫 迷走神经刺激术 认知 

分 类 号：R742.1[医药卫生—神经病学与精神病学]