CAJ | 학술논문

目的：评估术前M RI检查对药物难治性额叶癫痫手术患者术后6个月及1年预后的作用。方法：通过M RI等影像学检查及电临床症状学等评估手段确诊为额叶癫痫的患者20例，按照M RI检查有无异常发现分为两组，I组：M RI未发现病灶7例，II组：M RI有明确病灶13例，经过手术治疗后，随访半年及1年，按照Engle术后疗效评估分级法，并应用SPSS 17．0软件计算两组在短期预后上有无显著性差异。结果：20例患者术后半年达到Engle分级I级13例，占65．0％，术后1年达到Engle分级I级11例，占55．0％，其中I组患者术后半年达到Engle分级I级2例，占28．6％，术后1年达到Engle分级I级1例，占14．3％，而II组患者术后半年达到Engle分级I级11例，占84．6％，术后1年达到Engle分级I级10例，占76．9％，两组患者在手术疗效上有显著性差异（P＜0．05）。结论：手术切除癫痫病灶是药物难治性额叶癫痫的有效治疗方法，有明确病灶且病灶与癫痫发作相关的患者手术术后效果较好，针对M RI未见明确异常的患者可行颅内电极植入，对于深部癫痫病灶的评估具有明确作用。
목적：평고술전M RI검사대약물난치성액협전간수술환자술후6개월급1년예후적작용。방법：통과M RI등영상학검사급전림상증상학등평고수단학진위액협전간적환자20례，안조M RI검사유무이상발현분위량조，I조：M RI미발현병조7례，II조：M RI유명학병조13례，경과수술치료후，수방반년급1년，안조Engle술후료효평고분급법，병응용SPSS 17．0연건계산량조재단기예후상유무현저성차이。결과：20례환자술후반년체도Engle분급I급13례，점65．0％，술후1년체도Engle분급I급11례，점55．0％，기중I조환자술후반년체도Engle분급I급2례，점28．6％，술후1년체도Engle분급I급1례，점14．3％，이II조환자술후반년체도Engle분급I급11례，점84．6％，술후1년체도Engle분급I급10례，점76．9％，량조환자재수술료효상유현저성차이（P＜0．05）。결론：수술절제전간병조시약물난치성액협전간적유효치료방법，유명학병조차병조여전간발작상관적환자수술술후효과교호，침대M RI미견명학이상적환자가행로내전겁식입，대우심부전간병조적평고구유명학작용。
Objective :To assess the relationship between preoperative MRI and prognosis of refractory frontal epilepsy treated by frontal lobectomy after half an year and one year .Methods :In 20 frontal lobe epilepsy patients diagnosed by ictal semeiology and video EEG ,we divided them into two groups according to MRI ,there were 7 patients with non lesional in group I ,and 13 patients in group II with lesional .We calculated the statistical difference between group I and group II according to Engle classification of postoperative outcome .Results :In 20 pa-tients ,13 patients were seizure-free(Engle-I) half-an-year after surgery ,11 patients were seizure-free one year after suegery .2 patients were seizure-free half-an-year after surgery ,and the number was 1 one year after surgery in group I .11 patients were seizure-free half-an-year after surgery ,and the number was 10 one year after surgery in group II .There was statistical difference between the two groups .Conclusion :Epilepsy surgery evolved to an effec-tive treatment option for refractory frontal lobe epilepsy ;The patients with lesions correlated to clinical seizure should be treated by surgery ,and the outcome is good .Intracranial electrode electroencephalogram is an effective method to assess the lesion of epilepsy .