脑电图检查在功能性大脑半球切除术中的应用  

Application of electroencephalogram examination in functional hemispherectomy

作　　者：崔晨晨 肖其华 崔桂云 唐海 王小鹏 崔程程 龚向瑶 周曼莉 CUI Chen-chen;XIAO Qi-hua;CUI Gui-yun;TANG Hai;WANG Xiao-peng;CUI Cheng-cheng;GONG Xiang-yao;ZHOU Man-li(Department of Functional Neurosurgery,Affiliated Hospital of Xuzhou Medical University,Xuzhou Jiangsu 221000,China;Epilepsy Center,Affiliated Hospital of Xuzhou Medical University,Xuzhou Jiangsu 221000,China)

机构地区：[1]徐州医科大学附属医院功能神经外科,江苏徐州221000 [2]徐州医科大学附属医院癫痫中心,江苏徐州221000

出　　处：《局解手术学杂志》2023年第7期597-599,共3页Journal of Regional Anatomy and Operative Surgery

摘　　要：目的探讨脑电图(EEG)检查(包括术前、术中及术后)在预测功能性大脑半球切除术治疗药物难治性癫痫疗效中的价值。方法回顾性分析46例行功能性大脑半球切除术的药物难治性癫痫患者的临床资料,分析术前视频脑电图(V-EEG)、术中皮层及深部EEG、术后V-EEG。分析EEG定位结果与术后疗效的关系,从而探讨EEG的预测价值。结果功能性大脑半球切除术后癫痫发作消失37例(80.4%),仍有发作9例(19.6%)。术前V-EEG评估定位对手术疗效无明显影响,术中EEG发现异常放电者术后无发作率为89.7%,明显高于无异常放电者的28.9%(P<0.05),术后3个月或6个月对侧有异常放电9例患者,随访2年均出现癫痫发作。结论EEG检查与功能性大脑半球切除术疗效存在相关性,结合患者临床资料可有效预测功能性大脑半球切除术的疗效。Objective To explore the value of electroencephalogram(EEG)examination(including preoperative,intraoperative and postoperative)in predicting the efficacy of functional hemispherectomy in the treatment of drug-resistant epilepsy.Methods The clinical data of 46 patients with drug-resistant epilepsy who underwent functional hemispherectomy were retrospectively analyzed,focusing on the preoperative video-electroencephalogram(V-EEG),intraoperative cortical and deep EEG,and postoperative V-EEG.The relationship between EEG localization results and postoperative curative effect was analyzed to explore the predictive value of EEG.Results After functional hemispherectomy,seizures disappeared completely in 37 cases(80.4%),and still occurred in 9 cases(19.6%).Preoperative V-EEG localization had no significant effect on the outcome of the operation,the postoperative seizure-free rate of patients with abnormal dis-charge on EEG during operation was 89.7%,which was significantly higher than 28.9%of patients without abnormal discharge on EEG(P<0.05).There were 9 cases with abnormal contralateral discharge 3 months or 6 months after surgery,seizure occurred in all patients after 2 years of follow-up.Conclusion There is a correlation between EEG examination and the efficacy of functional cerebral hemi-spherectomy,combined with the clinical data of patients,it can effectively predict the efficacy of functional cerebral hemispherectomy.

关 键 词：功能性大脑半球切除术 癫痫 脑电图 

分 类 号：R61[医药卫生—外科学]