医药前沿
醫藥前沿
의약전연
YIAYAO QIANYAN
2013年
31期
128-129,130
,共3页
王一平%李慧卿%颜杨%王晓勇
王一平%李慧卿%顏楊%王曉勇
왕일평%리혜경%안양%왕효용
颅脑外伤%继发性癫痫%发病机制%药物治疗
顱腦外傷%繼髮性癲癇%髮病機製%藥物治療
로뇌외상%계발성전간%발병궤제%약물치료
Traumatic brain injury%Secondary epilepsy%Pathogenesis%Drug treatment
目的：探讨颅脑外伤后癫痫发生的可能机制和危险因素，为临床早期预防和治疗提供依据。方法回顾性分析1228例颅脑外伤患者中142例继发性癫痫患者的临床资料，重点探讨脑损伤类型、严重程度和脑损伤部位与发生癫痫的关系，研究癫痫与脑电图检查情况的关系。结果开放性颅脑损伤癫痫发生率（29.27%）明显高于闭合性脑损伤（8.01%）；重型脑损伤癫痫发生率（25.06%）明显高于轻型损伤（2.67%）；顶叶损伤癫痫发生率最高（51.11%）；外伤性癫痫脑电图检查首次异常率为83.10%。经两年正规抗癫痫治疗，基本可完全控制。结论脑外伤继发性癫痫以开放性损伤、重型损伤发生率高，顶叶损伤最易发生癫痫，发作形式以部分性发作居多，脑电图检查在本病的诊断和指导治疗中具有重要意义。开放性颅脑损伤，脑挫裂伤并脑内血肿，弥漫性轴索损伤，凹陷性骨折可能是外伤性癫痫的危险因素，选择恰当的方法治疗可降低发病率，提高疗效。
目的：探討顱腦外傷後癲癇髮生的可能機製和危險因素，為臨床早期預防和治療提供依據。方法迴顧性分析1228例顱腦外傷患者中142例繼髮性癲癇患者的臨床資料，重點探討腦損傷類型、嚴重程度和腦損傷部位與髮生癲癇的關繫，研究癲癇與腦電圖檢查情況的關繫。結果開放性顱腦損傷癲癇髮生率（29.27%）明顯高于閉閤性腦損傷（8.01%）；重型腦損傷癲癇髮生率（25.06%）明顯高于輕型損傷（2.67%）；頂葉損傷癲癇髮生率最高（51.11%）；外傷性癲癇腦電圖檢查首次異常率為83.10%。經兩年正規抗癲癇治療，基本可完全控製。結論腦外傷繼髮性癲癇以開放性損傷、重型損傷髮生率高，頂葉損傷最易髮生癲癇，髮作形式以部分性髮作居多，腦電圖檢查在本病的診斷和指導治療中具有重要意義。開放性顱腦損傷，腦挫裂傷併腦內血腫，瀰漫性軸索損傷，凹陷性骨摺可能是外傷性癲癇的危險因素，選擇恰噹的方法治療可降低髮病率，提高療效。
목적：탐토로뇌외상후전간발생적가능궤제화위험인소，위림상조기예방화치료제공의거。방법회고성분석1228례로뇌외상환자중142례계발성전간환자적림상자료，중점탐토뇌손상류형、엄중정도화뇌손상부위여발생전간적관계，연구전간여뇌전도검사정황적관계。결과개방성로뇌손상전간발생솔（29.27%）명현고우폐합성뇌손상（8.01%）；중형뇌손상전간발생솔（25.06%）명현고우경형손상（2.67%）；정협손상전간발생솔최고（51.11%）；외상성전간뇌전도검사수차이상솔위83.10%。경량년정규항전간치료，기본가완전공제。결론뇌외상계발성전간이개방성손상、중형손상발생솔고，정협손상최역발생전간，발작형식이부분성발작거다，뇌전도검사재본병적진단화지도치료중구유중요의의。개방성로뇌손상，뇌좌렬상병뇌내혈종，미만성축색손상，요함성골절가능시외상성전간적위험인소，선택흡당적방법치료가강저발병솔，제고료효。
Objective To Explore possible mechanisms of epilepsy after traumatic brain injury( TBI) and risk factors, and provide the basis for clinical prevention and early treatment. Methods 142 patients with secondary epilepsy were retrospectively analyzed from 1228 patients with TBI. The relationship between epilepsy and type of brain injury, severe head injury, brain injured parts, the Electroencephalogram examination were summarized. Results The incidence of secondary epilepsy in open brain injury(29.327%) was significantly higher than the internal head injury (8.01%); The incidence of secondary epilepsy with Serious injury (25.06%) ,significantly higher than the minor injuries (2.67%); The parietal lobe damage cause epilepsy is the highest (51.11%);The abnormal rate of traumatic epilepsy electroencephalogram (EEG) examination in the first time is 83. 10%After two years of antiepileptic treatment, the secondary epilepsy was basicly complete control ed. Conclusions The formation rate of TB I with secondary epilepsy is higher in the of the open injury and severe injury , the parietal lobe injury prone to seizures, forms of attack in the majority with partial seizures, electroencephalogram (EEG) examination in the diagnosis of the disease and guiding treatment is of great significance. Open craniocerebral injury and cerebral contusion of brain hematoma, diffuse axonal injury, pitting skul fracture may be a risk factor for traumatic epilepsy. Choosing the right treatment can decrease the incidence of a disease and improve the curative effect.
