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目的探讨手术治疗部分性癫痫患儿的远期疗效。方法回顾性分析2005年6月至2008年6月在斯坦伦布什大学泰格堡儿童医院该院接受外科手术治疗的158例部分性癫痫患儿的临床资料,观察患儿术后生活质量、智商改善及癫痫控制情况,并对影响手术远期疗效的相关因素进行分析。结果术后对患儿随访5年,158例患儿术后1、3、5年癫痫控制率分别为100.00%、94.85%、94.35%,其中MRI结果及病程是影响癫痫控制率的独立危险因素。智商1、3、5年改善率分别为89.87%、89.71%、88.71%,其中病程、手术年龄是影响患儿智商改善效果的独立危险因素。术后1、3、5年生活质量改善率分别为93.04%、91.18%、90.32%,其中术前智商、手术方式是影响患儿术后生活质量的独立危险因素。结论尽早对患儿实施手术,改善患儿病灶范围,能有效控制癫痫发作,改善患儿智商水平,提高患儿术后生活质量。
Objective To investigate the long-term effect of surgical treatment of children with partial epilepsy. Methods A retrospective analysis of clinical data of 158 cases of partial epilepsy in the hospital of Steinberg Children’s Hospital of Stellenbosch University from June 2005 to June 2008 was performed to observe the postoperative quality of life, Improve and control of epilepsy, and analyze the related factors that affect the long-term effect of surgery. Results The children were followed up for 5 years. The control rates of epilepsy in one hundred and seventy-five and one-year postoperative patients were 100.00%, 94.85% and 94.35% respectively. The MRI findings and course of disease were independent risk factors of epilepsy control . The improvement rates of IQ in 1, 3, 5 years were 89.87%, 89.71% and 88.71% respectively. The course of disease and the age of surgery were independent risk factors for improving the IQ of children. The quality of life improvement at 1, 3 and 5 years after operation was 93.04%, 91.18% and 90.32% respectively. The preoperative IQ and operation method were independent risk factors for postoperative quality of life. Conclusion As soon as possible, the operation of children, improve the range of children’s lesions, can effectively control the seizures, improve the level of intelligence in children and improve the quality of life of children.