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目的探讨迷走神经刺激术治疗药物难治性癫的疗效和术后最佳刺激参数。方法共71例药物难治性癫患者均接受迷走神经刺激术,Mc Hugh分级评价手术疗效,术后行刺激参数调试以达到最佳疗效。结果本组患者术后随访3~56个月、中位值22个月,癫发作频率较术前减少[18(3,92)次/月对30(5,145)次/月;Z=826.500,P=0.000]。发作频率减少<50%者20例(28.17%)、≥50%者51例(71.83%),其中27例(38.03%)发作频率减少≥80%,14例(19.72%)发作停止。本组有8例(11.27%)使用磁铁后发作严重程度减轻。结论迷走神经刺激术是一种治疗药物难治性癫安全、有效的方法。最佳刺激参数一般为刺激电流1.00~1.75 m A,0.75 m A也是有效刺激电流,同时需综合多个参数调试以达到最佳疗效。
Objective To investigate the efficacy of vagus nerve stimulation in the treatment of drug refractory epilepsy and the optimal stimulation parameters after surgery. Methods A total of 71 patients with drug refractory epilepsy received vagal nerve stimulation. Mc Hugh’s classification was used to evaluate the effect of the surgery. After the procedure, stimulation parameters were adjusted to achieve the best effect. Results The patients were followed up for 3 to 56 months with a median of 22 months. The frequency of epileptic seizures was decreased from 18 (3,92) to 30 (5,145) / month; Z = 826.500 , P = 0.000]. The seizure frequency was reduced by 50% in 20 cases (28.17%) and in 50% (51.81%). Seventy-seven cases (38.03%) had seizure frequency reduced by 80% and 14 cases (19.72%) stopped seizure. The group of 8 patients (11.27%) the severity of the use of magnets to reduce. Conclusion Vagus nerve stimulation is a safe and effective method for the treatment of refractory epilepsy. The best stimulation parameters are generally stimulation current 1.00 ~ 1.75 m A, 0.75 m A is also effective stimulation current, at the same time need to debug a number of parameters to achieve the best effect.