【摘要】：目的：探究難治性癲癇患者的外科治療手術(shù)療效,并對(duì)影響手術(shù)療效的有關(guān)因素進(jìn)行分析,以期得出影響預(yù)后的相關(guān)因素和控制癲癇發(fā)作的最佳治療計(jì)劃。方法：隨訪2009-07/2014-07在新疆醫(yī)科大學(xué)第一附屬醫(yī)院神經(jīng)外科行癲癇手術(shù)治療的108例,對(duì)其病例的病史、影像學(xué)檢查、電生理監(jiān)測等結(jié)果及其手術(shù)方案及術(shù)式和預(yù)后進(jìn)行回顧性分析。結(jié)果：發(fā)病年齡、致癇灶位置與術(shù)后患者預(yù)后無統(tǒng)計(jì)學(xué)差異(P0.05)。顳葉內(nèi)側(cè)癲癇手術(shù)效果最佳,患者病理結(jié)果與手術(shù)預(yù)后有統(tǒng)計(jì)學(xué)差異,胼胝體切除的手術(shù)預(yù)后最差,海馬杏仁核切除術(shù)的手術(shù)預(yù)后最為理想。術(shù)中腦電圖的變化與手術(shù)預(yù)后有統(tǒng)計(jì)學(xué)差異(P0.01),術(shù)中棘波數(shù)明顯減少者手術(shù)預(yù)后更佳。結(jié)論：符合手術(shù)指征的癲癇外科患者,需系統(tǒng)評(píng)估患者情況,選擇合適的手術(shù)方案。致癇灶的準(zhǔn)確定位,對(duì)于癲癇外科治療的成功至關(guān)重要。術(shù)中皮層腦電圖監(jiān)測,對(duì)于準(zhǔn)確切除病灶及致癇灶有指導(dǎo)性作用。
[Abstract]:Objective: to investigate the surgical efficacy of intractable epilepsy patients and analyze the related factors affecting the outcome of the operation in order to obtain the best treatment plan for the control of epileptic seizures. Methods: one hundred and eight patients with epilepsy treated by neurosurgery in the first affiliated Hospital of Xinjiang Medical University were followed up in 2009-07 / 2014-07. The results of electrophysiological monitoring, surgical procedures, surgical procedures and prognosis were retrospectively analyzed. Results: there was no significant difference in age, location of epileptogenic foci and prognosis of postoperative patients (P 0.05). The result of medial temporal lobe epilepsy was the best. The pathological results were significantly different from the operative prognosis. The prognosis of corpus callosum resection was the worst, and that of hippocampal amygdaloidectomy was the best. The change of electroencephalogram (EEG) was significantly different from the operative prognosis (P0.01). The operative prognosis was better when the number of spikes decreased significantly. Conclusion: patients with epileptic surgery who meet the surgical indications should be evaluated systematically and the appropriate procedure should be selected. Accurate location of epileptogenic foci is crucial to the success of surgical treatment of epilepsy. The monitoring of electrocortical electroencephalogram (EEG) during operation is instructive for accurate excision of lesions and epileptogenic foci.
【學(xué)位授予單位】：新疆醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R742.1

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