论文部分内容阅读
目的 探讨顽固性癫痫外科治疗的适应证、手术方法及临床疗效。方法 对 88例顽固性癫痫患者行外科治疗 ,其中 71例行立体定向手术 ,8例行胼胝体前部切开术 ,4例行前颞叶切除术 ,4例行致痫灶切除术 ,1例行致痫灶切除 +前颞叶切除 +多处软脑膜下横切术 (MST)。术后随访 1年以上。结果 2 0例(2 2 .8% )癫痫发作完全消失 ;36例 (4 0 .9% )癫痫发作显著减少 ;15例 (17.1% )效果良好 ;疗效差 9例(10 .2 % ) ;无明显改善 7例 (7.9% ) ;死亡 1例 (1.1% )。手术总有效率为 80 .8% ,显效率为 6 3.7%。通过分析不同术式 ,发现以前颞叶切除术疗效最好 ,胼胝体切开术效果最差。结论 外科手术是治疗顽固性癫痫的一种有效方法 ,但手术前应准确定位致痫灶 ,并选择适当的手术方式 ,以取得最佳的治疗效果
Objective To investigate the indications, surgical methods and clinical effects of intractable epilepsy surgical treatment. Methods Surgical treatment of 88 patients with intractable epilepsy were performed. Among them, 71 patients underwent stereotactic operation, 8 patients underwent anterior corpus callosotomy, 4 underwent anterior temporal lobectomy, 4 underwent epileptogenic surgery, and 1 patient Line epileptogenic resection + anterior temporal lobectomy + multiple subdural transection (MST). Follow-up after 1 year. Results Twenty-two (22.8%) seizures completely disappeared; 36 (40.9%) seizures were significantly reduced; 15 (17.1%) had good outcomes; 9 patients (10.2%) had poor response; No significant improvement in 7 cases (7.9%); 1 death (1.1%). The total operative efficiency was 80.8%, effective rate was 6 3.7%. Through the analysis of different surgical procedures, we found that the best effect of the previous temporal lobe resection, corpus callosum incision the worst. Conclusion Surgical operation is an effective method to treat intractable epilepsy. However, the epileptic foci should be accurately located before surgery and the appropriate surgical method should be chosen to obtain the best therapeutic effect