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目的研究迷走神经刺激术治疗难治性癫痫的适应证选择、手术方法、术后程控及疗效。方法 2009年11月~2016年7月清华大学玉泉医院癫痫中心对25例难治性癫痫患者行迷走神经刺激术,术后给予程控管理控制癫痫发作;并通过随访回顾性分析术后疗效。结果术后随访患者4个月~7年,其中癫痫发作频率减少达McHughⅠ级6例、Ⅱ级12例、Ⅲ级4例、Ⅳ级1例、Ⅴ级2例。手术前后癫痫发作频率对比,差异有统计学意义(P<0.05)。结论迷走神经刺激术作为一种安全有效的辅助治疗难治性癫痫的方法,其治疗效果可以随着参数的调整和时间延长而增强,并可以一定程度改善患者的认知行为和生活质量。
Objective To study the indications, surgical methods, procedural control and curative effect of vagus nerve stimulation in refractory epilepsy. METHODS: From November 2009 to July 2016, Yuchuan Hospital Epilepsy Center of Tsinghua University performed vagal nerve stimulation in 25 patients with refractory epilepsy and controlled by program-controlled management of epileptic seizures after operation. The postoperative efficacy was retrospectively analyzed by follow-up. Results The patients were followed up for 4 months to 7 years. Among them, the frequency of seizure decreased to 6 in McHugh Ⅰ, 12 in Ⅱ, 4 in Ⅲ, 1 in Ⅳ and 2 in Ⅴ. The frequency of seizures before and after surgery was significantly different (P <0.05). Conclusion Vagus nerve stimulation is a safe and effective method for adjuvant treatment of refractory epilepsy. Its therapeutic effect can be enhanced with the adjustment of parameters and time extension, and can improve patients’ cognitive behavior and quality of life to a certain extent.