国际外科学杂志
國際外科學雜誌
국제외과학잡지
INTERNATIONAL JOURNAL OF SURGERY
2011年
9期
618-621
,共4页
左保廷%范熙明%张卫星%翟宝进
左保廷%範熙明%張衛星%翟寶進
좌보정%범희명%장위성%적보진
聚焦超声波%局灶性癫痫%多软膜下横纤维切断术%皮层热凝%凝固性坏死
聚焦超聲波%跼竈性癲癇%多軟膜下橫纖維切斷術%皮層熱凝%凝固性壞死
취초초성파%국조성전간%다연막하횡섬유절단술%피층열응%응고성배사
Focused ultrasound%Focal epilepsy%Multiple subpial transaction%Cortex thermocoagulation%Coagulative necrosis
目的 探讨聚焦超声波对猫功能区局灶性癫痫治疗的安全性、有效性及治疗机制。方法 建立青霉素诱发的猫运动区局灶性癫痫模型。给予不同的治疗方式，通过行为学观察及脑电图监测，比较聚焦超声、皮层热凝及多软膜下横纤维切断术在控制癫痫发作方面的效果及运动区功能保护方面的差异；通过对治疗区脑组织进行组织病理学观察，比较3种处理因素在治疗机制上的差别。结果 在控制癫痫发作及脑电图改变方面，聚焦超声治疗与皮层热凝及多软膜下横纤维切断术相比较，差异均无统计学意义(P＞0.05)。聚焦超声与皮层热凝的病理学改变均表现为皮质浅层神经细胞的缺血性改变甚至凝固性坏死。多软膜下横纤维切断术组的病理改变主要表现为垂直于皮层表面、深达皮层深层的不规则裂隙，周围可见明显的水肿带，有不同程度胶质增生。结论 聚焦超声波能有效地破坏和切断皮层的水平纤维联系，同时该皮质的正常功能仍可以保留，因此对功能区局灶性癫痫的治疗与MST及皮层热凝同样安全、有效。
目的 探討聚焦超聲波對貓功能區跼竈性癲癇治療的安全性、有效性及治療機製。方法 建立青黴素誘髮的貓運動區跼竈性癲癇模型。給予不同的治療方式，通過行為學觀察及腦電圖鑑測，比較聚焦超聲、皮層熱凝及多軟膜下橫纖維切斷術在控製癲癇髮作方麵的效果及運動區功能保護方麵的差異；通過對治療區腦組織進行組織病理學觀察，比較3種處理因素在治療機製上的差彆。結果 在控製癲癇髮作及腦電圖改變方麵，聚焦超聲治療與皮層熱凝及多軟膜下橫纖維切斷術相比較，差異均無統計學意義(P＞0.05)。聚焦超聲與皮層熱凝的病理學改變均錶現為皮質淺層神經細胞的缺血性改變甚至凝固性壞死。多軟膜下橫纖維切斷術組的病理改變主要錶現為垂直于皮層錶麵、深達皮層深層的不規則裂隙，週圍可見明顯的水腫帶，有不同程度膠質增生。結論 聚焦超聲波能有效地破壞和切斷皮層的水平纖維聯繫，同時該皮質的正常功能仍可以保留，因此對功能區跼竈性癲癇的治療與MST及皮層熱凝同樣安全、有效。
목적 탐토취초초성파대묘공능구국조성전간치료적안전성、유효성급치료궤제。방법 건립청매소유발적묘운동구국조성전간모형。급여불동적치료방식，통과행위학관찰급뇌전도감측，비교취초초성、피층열응급다연막하횡섬유절단술재공제전간발작방면적효과급운동구공능보호방면적차이；통과대치료구뇌조직진행조직병이학관찰，비교3충처리인소재치료궤제상적차별。결과 재공제전간발작급뇌전도개변방면，취초초성치료여피층열응급다연막하횡섬유절단술상비교，차이균무통계학의의(P＞0.05)。취초초성여피층열응적병이학개변균표현위피질천층신경세포적결혈성개변심지응고성배사。다연막하횡섬유절단술조적병리개변주요표현위수직우피층표면、심체피층심층적불규칙렬극，주위가견명현적수종대，유불동정도효질증생。결론 취초초성파능유효지파배화절단피층적수평섬유련계，동시해피질적정상공능잉가이보류，인차대공능구국조성전간적치료여MST급피층열응동양안전、유효。
Objective To investigate the safety, efficacy and therapeutic mechanism of focused ultrasound surgery (FUS) on focal epilepsy of brain functional area in cat. Methods The focal epileptic models in the cats' motor cortex by penicillin were established. The different techniques were apphed in the animals epilepsy model. FUS, cortex thermocoagulation and multiple subpial transaction (MST) were compared in seizure control and functional preservation by observing behavior and electroencephalogram ( EEG), and the therapentic mechanism was compared by analysis of histopathology in the damaged cortex. Results In seizure control and EEG changes, three kinds of techniques were similar without prominent difference in statistics (P ＞ 0.05). The same pathologic changes were showed in FUS group and cortex thermocoagulation group, ischemic change and coagulative necrosis of superficial layer nerval cells. The major pathologic change in MST group was an irregular crevice which was vertical with the surface of the cortex. The edema and mild gliosis were found around the crevice. Conclusions The focused ultrasound can effectively destroy and cut off the association of cortical horizontal fibre, meanwhile, the cortical function still to be reserved.Therefore, FUS is safe and effective as well as MST and cortex thermocoagulation on focal epilepsy in brain functional area.
