【摘要】：目的探討藥物難治性半球病變性癲癇手術(shù)療效,并對(duì)功能性大腦半球切除術(shù)和大腦半球離斷術(shù)兩種手術(shù)方式作比較。方法回顧性分析2005年至2017年在我科手術(shù)治療的25例藥物難治性半球病變性癲癇患者,根據(jù)所行手術(shù)方式分為功能性大腦半球切除術(shù)組(FH)15例,大腦半球離斷術(shù)組(H)10例,對(duì)手術(shù)時(shí)間、術(shù)中出血、圍手術(shù)期并發(fā)癥、術(shù)后癲癇控制、神經(jīng)功能作回顧性研究。結(jié)果術(shù)后隨訪1~12年,平均隨訪5.28±2.91年。除去失訪2例總的癲癇發(fā)作控制率為Engel Ia 19例(82.60%)、Engel Id 3例(13.04%)、Engel IIa 1例(4.36%)。在癲癇控制率上,FH組與H組比無差異(p0.05)。在手術(shù)時(shí)間上,FH組手術(shù)時(shí)間較H組長(zhǎng),在術(shù)中失血上,FH組高于H組,且上述差異均有統(tǒng)計(jì)學(xué)意義(p0.05)。結(jié)論大腦半球切除術(shù)是一種有效的難治性半球病變性癲癇治療措施,術(shù)后不僅能有效控制癲癇發(fā)作,且部分患者神經(jīng)功能還得到改善,而大腦半球離斷術(shù)作為一種創(chuàng)傷更小、療效相當(dāng)?shù)氖中g(shù)方式,值得推廣。
[Abstract]:Objective to investigate the curative effect of drug-resistant hemispheric epilepsy and to compare the two operative methods: functional hemispherectomy and hemispheric amputation. Methods from 2005 to 2017, 25 patients with drug-resistant hemispheric lesion epilepsy who were treated by our department from 2005 to 2017 were retrospectively analyzed. According to the operative methods, 15 patients were divided into functional hemispheric resection group (FH) group) and functional cerebral hemispheric resection group (FH) group). 10 cases of (H) were treated with hemispheric hemispheres. The operative time, intraoperative bleeding, perioperative complications, postoperative epilepsy control and neurological function were studied retrospectively. Results the postoperative follow-up ranged from 1 to 12 years (mean 5.28 鹵2.91 years). The total seizure control rate was Engel Ia in 19 (82.60%), Engel Id in 3 (13.04%), Engel IIa in 1 (4.36%). There was no difference in epileptic control rate between FH group and H group (p0.05). The operative time of FH group was higher than that of H group, and the blood loss in FH group was higher than that in H group (p0.05). Conclusion Hemispheres resection is an effective treatment for intractable hemispheric epilepsy. It can not only effectively control epileptic seizures, but also improve the neurological function of some patients. The operative method with similar curative effect is worth popularizing.
【作者單位】： 安徽醫(yī)科大學(xué)解放軍174臨床學(xué)院;解放軍第一七四醫(yī)院神經(jīng)醫(yī)學(xué)中心;解放軍第一七四醫(yī)院麻醉科;
【基金】：南京軍區(qū)醫(yī)學(xué)科技創(chuàng)新課題(ZD26)
【分類號(hào)】：R651.1

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