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本文报告采用胼胝体前部切开配合主要痫灶多软膜下横切术治疗皮层广泛性痫灶的顽固性全身性癫痫26例.一期手术23例,均实施胼胝体前部切开,其中配合左额叶横切8例;右额叶横切9例;跨矢状窦开颅双侧额叶横切6例.分期手术3例,一期均实行单纯胼胝体前部切开术,二期行左额叶横切1例;右额叶横切2例,其中1例三期还施行了右顶枕叶横切.随访1~4年,发作消失12例,占46.2%;减少75%以上10例,占38.5%;减少50%以上3例,占11.5%;无效1例,占3.8%。总有效率为96.2%,显效率为84.7%.无手术死亡及严重并发症.结果表明,胼胝体切开术配合主要痈灶多软膜下横切术可明显提高手术疗效.
This article reports the use of the anterior corpus callosum with the main epileptogenic multi-subtotal transection of cortical epilepsy treatment of refractory generalized epilepsy in 26 cases of a surgery in 23 cases were performed anterior corpus callosum incision, Left frontal cross-section in 8 cases; right frontal cross-section in 9 cases; cross sagittal sinus cranial bilateral frontal lobe transversal in 6 cases. Staging surgery in 3 cases, a period of implementation of the simple corpus callosum anterior incision, The left frontal lobe transected in 1 case, the right frontal lobe transected in 2 cases, of which 1 case of the third stage also performed the right top occipital lobe transection.From 1 to 4 years follow-up, episode disappeared in 12 cases, accounting for 46.2%; reduced by 75% More than 10 cases, accounting for 38.5%; reduced by 50% or more in 3 cases, accounting for 11.5%; 1 invalid, accounting for 3.8%. The total effective rate was 96.2% and the markedly effective rate was 84.7% .There was no operative death and serious complications.The results showed that the corpus callosotomy combined with the major submucosal transection can significantly improve the curative effect.