迷走神经刺激术对不同年龄药物难治性癫痫患者的差异性研究  

Efficacy and safety of vagus nerve stimulation in children with drug-resistant epilepsy

作　　者：刘钰晔 谭泊静[4] 马延山[5] 桑林[5] 张凯[2] 杨岸超[1] 孟凡刚 张建国[1] LIU Yuye;TAN Bojing;MA Yanshan;SANG Lin;ZHANG Kai;YANG Anchao;MENG Fangang;ZHANG Jianguo(Department of Functional Neurosurgery,Beijing Tiantan Hospital,Capital Medical University,Beijing 100070,China;不详)

机构地区：[1]首都医科大学附属北京天坛医院功能神经外科,北京100070 [2]首都医科大学附属北京天坛医院癫痫外科,北京100070 [3]北京市神经外科研究所 [4]首都儿科研究所附属儿童医院神经外科 [5]北京丰台医院神经外科

出　　处：《临床神经外科杂志》2025年第1期2-5,13,共5页Journal of Clinical Neurosurgery

基　　金：国家重点研发计划资助项目(2021YFC2401201)。

摘　　要：目的比较迷走神经刺激术(VNS)对儿童和非儿童药物难治性癫痫患者的疗效。方法回顾性纳入2022年1月—2023年1月于首都医科大学附属北京天坛医院、北京丰台医院接受VNS治疗的69例癫痫患者,分析其疗效、并发症和程控情况。将所有患者分为两组,其中<12岁的儿童组31例,≥12岁的非儿童组38例,比较儿童组和非儿童组手术患者差异。应答者定义为发作减少率≥50%的患者,分别使用Mann-Whitney U检验、χ^(2)检验。结果术后1年和2年整体应答率为40.6%(28/69)和46.4%(32/69),无发作率由8.7%上升至14.5%。儿童组有应答比例更高,分别达到了41.9%和51.6%,而非儿童组为39.5%和42.1%。儿童组术后2年应用电流更高,两组术后无严重并发症,儿童的VNS手术植入风险并未增加。结论儿童组和非儿童组应用VNS治疗药物难治性癫痫均取得了良好的效果,经过综合评估后的符合适应证的患者可适时手术。Objective To evaluate the efficacy and safety of vagus nerve stimulation(VNS)in children with drug-resistant epilepsy.Methods A total of 69 patients treated with VNS at Beijing Tiantan Hospital and Beijing Fengtai Hospital from January 2022 to January 2023 were collected retrospectively.Efficacy,complications and programming were analyzed.All patients were divided into two groups,with 31 cases in children's group under 12 years old and 38 cases in non children's group over 12 years old.The differences in surgical patients between the children's group and the non children's group were compared.The respondents were defined as those with≥50%seizure reduction and Mann-Whitney U test andχ^(2)test were used respectively.Results At 1 and 2 years follow-up,response rates were 40.6%and 46.4%,respectively,with seizure-free rates rising from 8.7%to 14.5%.Children'showed higher response rates(41.9%and 51.6%)compared to non-child group(39.5%and 42.1%).Therefore,children received higher current levels 2 years after surgery.Postoperative complications were wild in both groups,and risks of VNS implantation surgery did not increase in children.Conclusions Both the children and non-children groups achieve good outcomes with VNS treatment for drug-resistant epilepsy.Patients who meet the criteria after comprehensive assessment can undergo surgery at an appropriate time.

关 键 词：迷走神经刺激术 癫痫 儿童 

分 类 号：R742.1[医药卫生—神经病学与精神病学]