癫痫的外科治疗(附138例报告)

目的 回顾性分析138例癫痫患者的手术治疗.方法 138例手术治疗的癫痫患者,通过术前评估,实施切除性手术119例(86.2%),胼胝体前部切开术11例(8.0%),切除性手术联合姑息性手术8例(5.8%).手术均在脑电图监测下进行,其中35例行术中电刺激定位脑功能区.结果 随访3-66个月,平均随访22个月,期间3例因肿瘤复发死亡,10例失访.纳入125例,对随访6个月以上的114例采取国内手术疗效标准评价,癫痫控制满意89例(78.1%),显著改善10例(8.8%),良好11例(9.7%),效果差2例(1.7%),无改善2例(1.7%).结论 手术是一种有效的癫痫治疗方法 ,选择恰当的适应证和致痫区的准确定位及显微手术技术水平是提高手术效果的关键环节.

Surgical treatment of epilepsy (a report of 138 cases)

Objective To retrospectively analyze the surgical treatment of 138 epileptic cases.Methods 138 epileptics, treated withsurgical treatment. Among the total, 119 (86. 2%) were performed resection operation, 11 (8. 0%) corpus callosotomy, 8 (5.8%) resection surgery combined with palliative operation. All operation was performed under electroencephalograqhic monitoring, and electrostimulation were performed for 35 cases to locate the eloquent brain area during surgery. Results Follow up time was 3 to 66 months. 3 cases died of tumor recurrence, 10 failed in follow up, 125 cases were brought into evaluation, among which, 114 cases had been followed up for over 6 months. Surgical effect were evaluated with evaluation system of TAN Qi - fu surgical effect classification, satisfactory in 89 cases (78. 1%),significantly improved in 10 cases (8. 8%), moderate improvement in 11 cases (9. 7%), mild improvement in 2 cases (1.7%), unchanged in 2 cases (1.7%). Conclusion Surgery is an effective treatment for epilepsy, and the key process of improving surgical effect include suitable indication, precise location of epileptogenic zone, level of surgical technique.