中华神经外科杂志
中華神經外科雜誌
중화신경외과잡지
Chinese Journal of Neurosurgery
2009年
5期
399-402
,共4页
刘仕勇%安宁%杨辉%张可成%杨梅华%宋业纯%阴金波%侯智%廖伟%张琴%蔡方成
劉仕勇%安寧%楊輝%張可成%楊梅華%宋業純%陰金波%侯智%廖偉%張琴%蔡方成
류사용%안저%양휘%장가성%양매화%송업순%음금파%후지%료위%장금%채방성
癫痫%儿童%外科手术%皮质发育障碍
癲癇%兒童%外科手術%皮質髮育障礙
전간%인동%외과수술%피질발육장애
Epilepsy%Child%Surgical procedures,operative%Malformation of cortical dysplasia
目的 分析儿童难治性癫痫的病因、外科手术的适应证和预后.方法 回顾性分析采用外科手术治疗342例儿童癫痫的经验.结果 皮质发育障碍是本组儿童难治性癫痫的最重要病因,占18.4%.药物难治性癫痫综合征占13.5%.术后疗效Engel Ⅰ级158例,Ⅱ级76例,Ⅲ级61例,Ⅳ级47例.平均智商(1Q)从术前的69.2分提高到79.8分.术前显示智力低下者术后亦有明显改善.结论 早期外科干预能有效地控制癫痫发作、改善智力损害,智力低下不应是外科治疗的禁忌证.同时,正确认识儿童难治性癫痫的病凶和病理埘儿童癫痫的外科治疗具有重要作用.
目的 分析兒童難治性癲癇的病因、外科手術的適應證和預後.方法 迴顧性分析採用外科手術治療342例兒童癲癇的經驗.結果 皮質髮育障礙是本組兒童難治性癲癇的最重要病因,佔18.4%.藥物難治性癲癇綜閤徵佔13.5%.術後療效Engel Ⅰ級158例,Ⅱ級76例,Ⅲ級61例,Ⅳ級47例.平均智商(1Q)從術前的69.2分提高到79.8分.術前顯示智力低下者術後亦有明顯改善.結論 早期外科榦預能有效地控製癲癇髮作、改善智力損害,智力低下不應是外科治療的禁忌證.同時,正確認識兒童難治性癲癇的病兇和病理塒兒童癲癇的外科治療具有重要作用.
목적 분석인동난치성전간적병인、외과수술적괄응증화예후.방법 회고성분석채용외과수술치료342례인동전간적경험.결과 피질발육장애시본조인동난치성전간적최중요병인,점18.4%.약물난치성전간종합정점13.5%.술후료효Engel Ⅰ급158례,Ⅱ급76례,Ⅲ급61례,Ⅳ급47례.평균지상(1Q)종술전적69.2분제고도79.8분.술전현시지력저하자술후역유명현개선.결론 조기외과간예능유효지공제전간발작、개선지력손해,지력저하불응시외과치료적금기증.동시,정학인식인동난치성전간적병흉화병리시인동전간적외과치료구유중요작용.
Objective To investigate the etiology, surgical indications and outcomes of pediatric intractable epilepsy. Method Surgery for 342 pediatric patients with intractable epilepsy between 1989-2007 were reviewed. The etiology was investigated according to the clinical data. Resection of epileptogenic foci or lobe, and/or multiple subpial transection (MST) was followed when a focal epileptic discharge was indicated according to preoperative evaluation and EcoG, but muhilobar resection with MST and/or corpus callosotomy were chosen to deal with hemispheric multiple epileptic foci. Results Malformation of cortical dysplasia was the most important pathology of pediatric intractable epilepsy. Intractable epilepsy syndromes were accounted for 13.5% of all pediatric intractable epilepsy. At follow-up on average 7.5 years after surgery,158 patients(45. 9%) had an Engel Class Ⅰ outcome after surgery and an additional 76 patients (22. 2%) had rare seizure (Engel Class Ⅱ), and 61 patients had a decrease in seizure frequency (Engel Class Ⅲ). Mean IQ improved from 69. 2 to 79. 8. Temporary complications were observed and there was no death. Conclusions Early surgical intervention in intractable pediatric epilepsy provides the good opportunity to control the seizure, prevent irreversible worse of intelligence. Imbecile IQ should not be a contra-indication of pediatric surgery. Understanding the etiology and pathology of pediatric intractable epilepsy will facilitate the surgery of pediatric epilepsy.
