中华神经外科杂志
中華神經外科雜誌
중화신경외과잡지
Chinese Journal of Neurosurgery
2012年
1期
20-23
,共4页
张苓%明扬%刘亮%刘洛同%顾应江%张智慧%陈礼刚
張苓%明颺%劉亮%劉洛同%顧應江%張智慧%陳禮剛
장령%명양%류량%류락동%고응강%장지혜%진례강
儿童%非病灶性%癫痫
兒童%非病竈性%癲癇
인동%비병조성%전간
Child%Non - lesion%Epilepsy
目的 对儿童非病灶性癫痫致痫灶功能定位、手术方式、手术疗效和手术前后认知功能改变的情况进行研究.方法 对21例经外科治疗的非病灶性癫痫患儿的术前定位、手术疗效和手术前后认知功能的改变进行回顾性分析,并以随机选择的20例健康学龄期儿童作为对照组.结果 21例患者中,手术疗效按Engel标准随访1年后,Ⅰ级13例,Ⅱ级4例,Ⅲ级3例,Ⅳ级1例.手术前后事件相关电位和学习障碍筛查量表结果显示术前组与对照组、术后组P300潜伏期差异均有统计学意义.结论 术前联合视频脑电图(VEEG)、fMRI、单光子发射断层扫描(SPECT)对致痫灶进行功能定位,结合其临床特点采用不同的手术治疗方式,加上术中使用皮层电极监测,是治疗儿童非病灶性癫痫的有效途径,能很好地改善患儿的认知功能障碍.
目的 對兒童非病竈性癲癇緻癇竈功能定位、手術方式、手術療效和手術前後認知功能改變的情況進行研究.方法 對21例經外科治療的非病竈性癲癇患兒的術前定位、手術療效和手術前後認知功能的改變進行迴顧性分析,併以隨機選擇的20例健康學齡期兒童作為對照組.結果 21例患者中,手術療效按Engel標準隨訪1年後,Ⅰ級13例,Ⅱ級4例,Ⅲ級3例,Ⅳ級1例.手術前後事件相關電位和學習障礙篩查量錶結果顯示術前組與對照組、術後組P300潛伏期差異均有統計學意義.結論 術前聯閤視頻腦電圖(VEEG)、fMRI、單光子髮射斷層掃描(SPECT)對緻癇竈進行功能定位,結閤其臨床特點採用不同的手術治療方式,加上術中使用皮層電極鑑測,是治療兒童非病竈性癲癇的有效途徑,能很好地改善患兒的認知功能障礙.
목적 대인동비병조성전간치간조공능정위、수술방식、수술료효화수술전후인지공능개변적정황진행연구.방법 대21례경외과치료적비병조성전간환인적술전정위、수술료효화수술전후인지공능적개변진행회고성분석,병이수궤선택적20례건강학령기인동작위대조조.결과 21례환자중,수술료효안Engel표준수방1년후,Ⅰ급13례,Ⅱ급4례,Ⅲ급3례,Ⅳ급1례.수술전후사건상관전위화학습장애사사량표결과현시술전조여대조조、술후조P300잠복기차이균유통계학의의.결론 술전연합시빈뇌전도(VEEG)、fMRI、단광자발사단층소묘(SPECT)대치간조진행공능정위,결합기림상특점채용불동적수술치료방식,가상술중사용피층전겁감측,시치료인동비병조성전간적유효도경,능흔호지개선환인적인지공능장애.
Objective To explore the identification of the localization of non - lesional epilepsy in children,surgical methods,surgical results and indicators of cognitive function before and after surgery.Method Localization and surgical results of 21 cases received surgical treatment and changes in cognitive function before and after surgery were reviewed,retrospectively,and randomly selected 20 normal school - age children as a control group.Results According to Engel scale,the results after follow - up for one year are 13 cases of Ⅰ grade,4 cases of Ⅱ grade,3 cases of Ⅲ grade and 1 case of Ⅳ grade.The results of ERPS and PRS shown that there was a significant difference between the groups( pre -operation group vs.post - operation group and control group).Conclusions It is an effective way to select appropriate surgical methods to NLE based on epileptic focus located by VEEG,fMRI,SPECT,clinical characteristics and using cortex electrodes EEG during operation.It can greatly improve children's cognitive dysfunction.