迷走神经刺激对癫痫患者生活质量影响的临床研究

目的评估迷走神经刺激对癫痫患者生活质量的影响。方法 14例药物难治性全身性癫痫患者进行迷走神经刺激术治疗,比较其术前及术后癫痫患者生活质量量表-31(QOLIE-31)评分的变化。结果平均随访12月,患者发作频率平均减少61.0%,其中5例发作频率减少<50%,6例发作频率减少≥50%,3例发作停止。癫痫患者生活质量量表总分从术前的50.5上升至术后的57.1,平均增加6.6(P=0.0276)。各个分量表中得分均有一定程度增加,其中认知功能、情绪两项改善有统计学意义。癫痫患者生活质量量表总分及7个分量表得分改善与发作减少均无相关性。结论迷走神经刺激是一种治疗药物难治性癫痫安全、有效的方法。其作用不仅体现在癫痫发作的减少,对生活质量也有一定的改善作用。而且这两者之间无相关性,提示生活质量改善是迷走神经刺激独立的临床疗效评价指标之一。

Effects of vagus nerve stimulation on quality of life in intractable epilepsy

Objective To evaluate the quality of life(QOL) impacts of vagus nerve stimulation therapy in intractable epilepsy.Methods Vagus Nerve Stimulation were performed in fourteen patients.QOLIE-31 tests were taken before implantation and after 6~12 months VNS treatment.Results The patients experienced a median seizure frequency reduction of 61.0% after 6~24 months of VNS therapy.In these fourteen patients,42.9%(n=6) had >or=50% seizure reduction,and 21.4%(n=3) had seizure free.The mean overall QOLIE-31 score increased significantly from 50.5 preoperatively to 57.1 after 6~24months of treatment for a mean change of 6.6.Seven subjects of QOLIE-31 score also increased.The mean overall and seven subjects of QOLIE-31 score did not correlate with changes in seizure frequency.Conclusion VNS is a safe and effective therapy and could improve the quality of life in refractory epilepsy.