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目的:探讨脑皮层电图(EcoG)监测在指导难治性癫痫手术中的应用价值,分析该术式的护理措施。方法:选择我院收治的难治性癫痫患者13例为研究对象,术前采用影像学、症状学和电生理学进行评估,术中应用EcoG精确定位引导切除范围。比较术前评估结果与术中EcoG探查情况,观察患者术后一般情况,评价护理效果,术后随访1个月~5年,记录并发症发生情况,采用Engel疗效分级标准评价疗效。结果:本组13例患者术中EcoG探查结果与术前评估结果基本一致,但术中EcoG探查定位更加精细准确,更有利于指导切除范围;术后发生失语、头皮下感染、复视和记忆力障碍的各1例,均在相应的处理后好转,无患者死亡;Engel分级Ⅰ级的8例,Ⅱ级的3例,Ⅲ级的1例,Ⅳ级的1例,有效率为92.31%;护理质量评分为(91.34±2.26)分,患者对护理的满意度评分为(89.37±4.71)分。结论:脑皮层电图监测在难治性癫痫手术中可精确引导手术切除范围,应给予全面的围手术期护理配合。
Objective: To investigate the value of cortical electrogalvanography (EcoG) monitoring in guiding refractory epilepsy surgery and to analyze the nursing measures. Methods: Thirteen patients with refractory epilepsy treated in our hospital were selected as the study objects. Imaging, symptomatology and electrophysiology were performed preoperatively. EcoG was used to accurately locate and guide the resection scope. The results of preoperative assessment and intraoperative EcoG exploration were compared. The general postoperative condition was evaluated and the nursing effect was evaluated. The patients were followed up for 1 month to 5 years. The incidence of complications was recorded. Engel’s efficacy classification was used to evaluate the curative effect. Results: The results of intraoperative EcoG exploration in this group of patients were basically the same as those of preoperative evaluation. However, the intraoperative EcoG exploration was more accurate and precise, which was more conducive to guiding the resection range. Postoperative aphasia, subcutaneous infection, diplopia and memory 1 case of obstacle improved after the corresponding treatment, and no patient died. The Engel grade Ⅰ was 8 cases, Ⅱ grade 3 cases, Ⅲ grade 1 case, and Ⅳ grade 1 case. The effective rate was 92.31%. The score of nursing quality was (91.34 ± 2.26) points, and the patient satisfaction score of nursing was (89.37 ± 4.71) points. Conclusion: Electrocorticogram monitoring can accurately guide the scope of surgical resection in refractory epilepsy surgery. Comprehensive perioperative nursing cooperation should be given.