颅内电极定位致痫灶在癫痫外科治疗中的应用研究  

Investigation on the application of intracranial electrode in locating epileptogenic focus in surgical treatment of epilepsy

作　　者：梁明礼[1] 刘文浩 罗兴达 邹友权[1] LIANG Mingli;LIU Wenhao;LUO Xingda;ZOU Youquan(DepartmentⅠof Neurosurgery,Meizhou People’s Hospital,Guangdong,Meizhou 514031,China)

机构地区：[1]广东省梅州市人民医院神经外一科,广东梅州514031

出　　处：《中国医药科学》2024年第22期126-129,共4页China Medicine And Pharmacy

基　　金：广东省梅州市社会发展科技计划项目(221208162057358)。

摘　　要：目的探讨颅内电极定位致痫灶在癫痫外科治疗中的应用效果。方法回顾性分析梅州市人民医院2016年1月至2022年5月收治的74例癫痫外科治疗患者的临床资料,根据患者是否应用颅内电极定位致痫灶,分为对照组(n=34)与观察组(n=40)。对照组借助长程视频头皮脑电监测或单纯影像学检查进行致痫灶定位,观察组借助颅内电极定位致痫灶,比较两组定位准确率与手术治疗效果。结果对照组定位准确29例,定位准确率为85.29%,观察组定位准确38例,定位准确率为95.00%,观察组致痫灶定位准确率高于对照组,差异有统计学意义(P<0.05);观察组癫痫放电检出率为95.00%,高于对照组的58.82%,差异有统计学意义(P<0.05);对照组术后Engel手术效果Ⅰ级13例、Ⅱ级16例、Ⅲ级5例,观察组术后Engel手术效果Ⅰ级32例、Ⅱ级6例、Ⅲ级2例,观察组治疗后Engel手术效果Ⅰ级率高于对照组,差异有统计学意义(P<0.05);两组术后并发症总发生率比较,差异无统计学意义(P>0.05)。结论颅内电极定位致痫灶在癫痫外科治疗中的应用效果确切,可使致痫灶得到准确定位,提升手术治疗的效果。Objective To investigate the efficacy of intracranial electrode in locating epileptogenic focus in surgical treatment of epilepsy.Methods The clinical data of 74 patients with epilepsy admitted to and treated in Meizhou People’s Hospital from January 2016 to May 2022 were retrospectively analyzed.According to whether the patients used intracranial electrodes to locate the epileptogenic focus,they were divided into the control group(n=34)and the observation group(n=40).The control group located the epileptogenic focus with the help of long-distance video scalp electroencephalogram monitoring or simple imaging examination,while the observation group located the epileptogenic focus with the help of intracranial electrodes.The positioning accuracy and surgical treatment efficacy of the two groups were compared.Results In the control group,the localization accuracy rate was 85.29%in 29 cases,and in the observation group,the localization accuracy rate was 95.00%in 38 cases.The localization accuracy rate of epileptogenic focus in the observation group was higher than that in the control group,with statistically significant differences(P<0.05).The detection rate of epileptic discharge in the observation group was 95.00%,higher than 58.82%in the control group,with statistically significant difference(P<0.05).In the control group,there were 13 cases with gradeⅠEngel surgery,16 cases with gradeⅡEngel surgery,and 5 cases with gradeⅢEngel surgery.While in the observation group,there were 32 cases with gradeⅠEngel surgery,6 cases with gradeⅡEngel surgery,and 2 cases with gradeⅢEngel surgery.After treatment,gradeⅠEngel surgery rates in the observation group were higher than those in the control group,with statistically significant differences(P<0.05).There was no statistically significant difference in the total incidence of postoperative complications between the two groups(P>0.05).Conclusion Intracranial electrode localization of epileptogenic focus is effective in surgical treatment of epilepsy,which can accu

关 键 词：癫痫 外科手术 颅内电极定位 致痫灶 手术效果 并发症 

分 类 号：R742.1[医药卫生—神经病学与精神病学]