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目的调查分析立体定向手术治疗对成年难治性癫痫患者生活质量的影响。方法对92例无明确致痫灶的成年难治性癫痫患者进行立体定向手术治疗,采用症状自评量表(SCL-90)、癫痫患者生活质量量表-31(QOLIE-31)在手术前及手术后半年、1年、2年、3年、4年、5年对患者进行连续评估。结果尽管部分患者术后癫痫症状不能完全控制,但患者总的生活质量在手术后各阶段均较术前明显提高。手术效果EngelⅠ级患者术后各时间段的生活质量优于Ⅱ~Ⅳ级患者的生活质量。术前具有明显精神症状患者术后各时间段的生活质量与术前无精神症状患者的术后生活质量比较无明显差异。结论对于经术前综合评估不能确定致痫灶,特别是伴有明显精神症状的难治性癫痫患者,立体定向手术治疗是一种有效的治疗手段,可显著改善这部分患者的生活质量。
Objective To investigate the effect of stereotactic surgery on quality of life in patients with refractory epilepsy. Methods Ninety-two adult patients with refractory epilepsy were treated with stereotactic surgery. The symptoms were assessed using the Self-rating Symptom Inventory (SCL-90), the Quality of Life Scale for Epilepsy-31 (QOLIE-31) Patients were followed up for six months, one year, two years, three years, four years, and five years after surgery. Results Although the symptoms of epilepsy in some patients were not completely controlled, the overall quality of life of patients was significantly improved at all stages after surgery. Surgical outcomes The quality of life of Engel class I patients at various time points after surgery was better than that of grade II-IV patients. There was no significant difference in quality of life between preoperative patients with significant psychiatric symptoms at various time points after operation and those without preoperative psychiatric symptoms. Conclusions Stereotactic surgery is an effective treatment for patients with epileptogenic lesions, especially refractory epilepsy with obvious psychiatric symptoms, assessed by preoperative comprehensive assessment, which can significantly improve the quality of life of this group of patients.