【摘要】：目的 探討大腦半球離斷術(shù)治療半球性病變導(dǎo)致的難治性癲癇的手術(shù)方法及療效。方法 回顧性收集寧夏醫(yī)科大學(xué)總醫(yī)院神經(jīng)外科2014年8月至2016年1月全部采用大腦半球離斷手術(shù)治療難治性癲癇患者的臨床資料,包括病史,臨床癥狀,影像學(xué)資料,視頻腦電圖檢測(cè)結(jié)果,采用相同的手術(shù)方術(shù),對(duì)患側(cè)大腦半球進(jìn)行分步離斷:先經(jīng)側(cè)裂切除海馬杏仁核;經(jīng)顳角沿三角區(qū)向額角分段皮層造瘺,分段離斷額葉、頂葉、枕葉與胼胝體的聯(lián)系;最后經(jīng)側(cè)裂切除島葉皮質(zhì)。結(jié)果 該術(shù)式在4例患者成功實(shí)施。術(shù)后4例患者獲全程隨訪,隨訪時(shí)間8-20個(gè)月,平均13個(gè)月。結(jié)果證實(shí),手術(shù)創(chuàng)傷小,并發(fā)癥少,術(shù)后病人沒有任何加重對(duì)側(cè)肢體功能障礙的并發(fā)癥,癲癇得到有效控制,Engel I級(jí)3例,EngelⅡ級(jí)1例。且術(shù)后恢復(fù)好,神經(jīng)心理,精神行為明顯改善。結(jié)論 大腦半球多腦葉離斷術(shù)是一種對(duì)半球性病變導(dǎo)致的難治性癲癇患者創(chuàng)傷小、療效可靠的治療方案。
[Abstract]:Objective To study the surgical method and curative effect of cerebral hemisphere off-cut in the treatment of intractable epilepsy caused by hemispheric lesion. Methods The clinical data from the neurosurgical department of the general hospital of Ningxia Medical University from August 2014 to January 2016 were retrospectively collected, including medical history, clinical symptoms, imaging data and video and EEG detection results. In the same procedure, the cerebral hemisphere of the affected side was divided by step: firstly, the amygdala of the hippocampus was cut off by the lateral fissure; the contact of the frontal lobe, the parietal lobe, the occipital lobe and the hippocampus of the frontal lobe of the frontal angle was divided into the frontal angle of the frontal angle along the triangle, and the cortex of the island of the island was cut through the lateral fissure. Results The operation was performed in 4 patients. The follow-up time was 8-20 months and the mean 13-month follow-up. The results showed that the operation was small, the complication was few, the postoperative patients did not have any complications of the contralateral limb dysfunction, the epilepsy was controlled effectively, the Engel I grade in 3 cases, Engel 鈪，

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