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目的分析采用杏仁核海马立体定向射频热凝毁损术(SAHE)治疗内侧颞叶癫痫的方法、癫痫控制情况及神经心理学功能影响,评估SAHE的效果及安全性。方法选取48例内侧颞叶癫痫行外科手术治疗患者为研究对象,分析其一般资料、SAHE治疗方法及术后癫痫发作消失率、神经心理学功能术后检测情况。结果手术均顺利完成,术后随访6个月~2年,癫痫完全控制率为52.1%,治疗显效率为75.0%,总有效率为89.6%,术后11例(22.9%)患者出现轻度头痛,9例(18.8%)患者术后出现低热,均为给予特殊治疗,未影响后续治疗,后1周患者PIQ、VIQ、MQ有所下降,但是在之后的随访中发现患者术后6个月在神经心理功能各维度评测结果均已恢复至术前水平,术后1周患者PIQ、VIQ、MQ有所下降,但是在之后的随访中发现患者术后6个月在神经心理功能各维度评测结果均已恢复至术前水平。结论 SAHE对内侧颞叶癫痫的治疗效果显著,能够有效的减少术后癫痫发作次数,术后早期会对患者的语言、操作智商、记忆力有一定影响,但长远观察可恢复正常,安全性良好,值得临床推广应用。
Objective To analyze the method of treatment of medial temporal lobe epilepsy by amygdala hippocampal stereotactic radiofrequency thermocoagulation (SAHE), the effects of epilepsy control and neuropsychological function to evaluate the safety and efficacy of SAHE. Methods Forty-eight patients with medial temporal lobe epilepsy undergoing surgical treatment were enrolled in this study. General information, SAHE treatment methods, postoperative disappearance rate of epileptic seizures and postoperative detection of neuropsychological function were analyzed. Results The operation was successfully completed. The follow-up period was 6 months to 2 years. The complete control rate of epilepsy was 52.1%, the effective rate was 75.0%, the total effective rate was 89.6%. Postoperative 11 patients (22.9%) had mild Headache, 9 patients (18.8%) were postoperative fever, were given special treatment, did not affect the follow-up treatment, after 1 week patients PIQ, VIQ, MQ decreased, but in the follow-up found in patients with postoperative 6 Month in all dimensions of neuropsychological function evaluation results have been restored to the preoperative level, 1 week after the patients PIQ, VIQ, MQ decreased, but in the follow-up found in patients with postoperative 6 months in neuropsychological function in all dimensions Evaluation results have been restored to the preoperative level. Conclusions SAHE has a significant therapeutic effect on medial temporal lobe epilepsy and can effectively reduce the number of postoperative seizures. The early postoperative period may have some impact on the patient’s language, operational intelligence and memory, but the long-term observation may return to normal and be safe. Worthy of clinical application.