颅内手术对脑机能影响的初步研究

目的 通过动态脑电图（AEEG）监测，分析手术前后的脑机能变化特点，了解手术对脑机能的影响。方法 选择260例经CT或MRI检测诊断为颅内占位性疾病者，术前1－3d、术后1周、1－3月分别观察其AEEG表现。结果 （1）AEEG术前异常率为88.1%。术后1周AEEG异常率（97.7%）及异常程序明显增加，1－3月的AEEG结果显示异常率（77.7％）及异常程度下降。（2）术前有癫痫发作（A组）112例，术后84例无临床发作，说明手术切除病灶对控制癫痫症状是有效的。（3）术前无癫痫发作（B组）148例，术后新发癫痫17例，提示手术对大脑皮质的损害，可能增加致痫机会。且A组28例遗传癫痫发作（阳性数高于B组），提示术前有癫痫发作的患者，术后更易发生癫痫。结论 开颅手术在治疗疾病的同时，对脑机能会产生一定的影响，甚至可能引起癫痫。

A preliminary study on effect of intracranial surgery in brain function

Objective To study,by monitoring of AEEG and analysing brain function feature before and after surgry,the effect of intracranial surgery in brain function.Methods In 260 patients with intracranial mass lesions diagnosed by using CT or MRI,AEEG was serially recorded during 1 3 days,before surgery as well as 1 week and 1 3 months after surgery.Results (1)AEEG was abnotrmal in 88 1% of all subjects before surgery.Both rate and degree of AEEG abnormality were significantly increased one week after surgery,but moderated one to three months after surgery.(2)112 patients (Group A)appear clinical seizures before surgery.84 of112 patients stopped the clinical seizures after surgery,which suggests that surgery is useful to control clinical seizures(3) 17of 148patients in Group B (had no clinical seizures before surgery) developed symptomatic seizures after surgery,which suggested that cortex injury during surgery might increase an incidence of epilepsy.28 patients in Group A still kept clinical seizures after surgery, which were higher than those in Group B.Conclusion Intracranial surgery can effect some degrees of brain function and possibly lead to epilepsy seizures.