CAJ | 학술논문

目的评估合并癫痫的海绵状血管畸形患者的手术治疗方法。 　　方法采用回顾性研究，收集我科住院的合并癫痫的海绵状血管畸形患者27例，对行完整切除海绵状血管畸形病灶（包括病灶周边的胶质瘢痕层和含铁血黄素层）和完整切除海绵状血管畸形病灶+皮层热灼治疗患者的癫痫预后及其他相关因素进行比较。 　　结果①完整切除病灶+皮层热灼术患者的癫痫预后明显好于仅完整切除病灶的患者（P=0.036）。②癫痫患病病程不足1年患者预后明显好于癫痫患病病程超过1年的患者（P=0.022）。③性别、年龄、病灶所在脑叶、癫痫发作形式、术前是否应用抗癫痫药物（antiepileptic drugs，AEDs）及术后功能状态评分（Karnofsky Performance Status Scale，KPS）对癫痫预后无显著影响。 　　结论对于合并癫痫的海绵状血管畸形患者应早期进行手术。术中应完整切除海绵状血管畸形病灶（包括病灶周边的胶质瘢痕层和含铁血黄素层），同时行皮层热灼术。
목적평고합병전간적해면상혈관기형환자적수술치료방법。 　　방법채용회고성연구，수집아과주원적합병전간적해면상혈관기형환자27례，대행완정절제해면상혈관기형병조（포괄병조주변적효질반흔층화함철혈황소층）화완정절제해면상혈관기형병조+피층열작치료환자적전간예후급기타상관인소진행비교。 　　결과①완정절제병조+피층열작술환자적전간예후명현호우부완정절제병조적환자（P=0.036）。②전간환병병정불족1년환자예후명현호우전간환병병정초과1년적환자（P=0.022）。③성별、년령、병조소재뇌협、전간발작형식、술전시부응용항전간약물（antiepileptic drugs，AEDs）급술후공능상태평분（Karnofsky Performance Status Scale，KPS）대전간예후무현저영향。 　　결론대우합병전간적해면상혈관기형환자응조기진행수술。술중응완정절제해면상혈관기형병조（포괄병조주변적효질반흔층화함철혈황소층），동시행피층열작술。
Objective To provide effective surgical methods for patients with cavernous malformation complicated with epilepsy. Methods Twenty-seven patients with cavernous malformation complicated with epilepsy in our department were retrospectively analyzed. Simultaneously, we compared different epilepsy prognosis and other relevant factors between patients accepted total resection (including the gliotic and hemosiderin-stained brain tissue adjacent to the lesions) and patients accepted total resection combined with cortex thermocoagulation. Results ① Prognosis of patients treated with total resection combined with cortex thermocoagulation was much better than those who only accepted total resection (P=0.036). ②Prognosis of patients whose course of epilepsy is less than 1 year was much better than those whose course is more than 1 year (P=0.022).③There were no statistical signiifcances for epilepsy prognosis in sex, age, the lobe where the cavernous malformation located, different epilepsy seizures, whether preoperative application of antiepileptic drugs (AEDs) and postoperative Karnofsky Performance Status Scale (KPS). Conclusion The analysis of outcome showed that patients with cavernous malformation complicated with epilepsy beneifted signiifcantly from early surgery. And at the same time, in order to achieve better effect from the surgery, total resection of cavernous malformation (including the gliotic hemosiderin-stained brain tissue adjacent to the lesions) must be adopted, and cortex thermocoagulation treatment should be applied.