CAJ | 학술논문

目的总结分析儿童部分性癫痫手术治疗效果和经验.方法回顾性分析2002年11月至2009年10月解放军总医院第一附属医院进行切除性手术治疗的278例6～ 14岁的部分性癫痫患者的临床资料.统计术后1年(1FU)、3年(3FU)和5年(5FU)癫痫控制情况,1FU时智商和生活质量的变化情况,比较癫痫发作形式、术前年龄、智商和手术方式等对手术效果的影响.结果 1FU、3FU和5FU时癫痫无发作率为82.0％ (228/278)、76.0％(130/171)和67.3％ (72/107),其中病程≤5年和局限性病理灶对癫痫控制有明显影响.智商和生活质量术后1年复查完成223例,总智商改善93例(41.7％),其中以术后无癫痫发作、术前低智商和病程≤5年者改善明显.生活质量术后改善141例(63.2％),其中以联合胼胝体切开术和智商低者改善明显.结论手术可使合理选择的儿童部分性癫痫患者,癫痫发作得以控制、长期认知得到改善,有局限性病理灶和早期手术对提高手术疗效有利.
목적 총결분석인동부분성전간수술치료효과화경험.방법 회고성분석2002년11월지2009년10월해방군총의원제일부속의원진행절제성수술치료적278례6～ 14세적부분성전간환자적림상자료.통계술후1년(1FU)、3년(3FU)화5년(5FU)전간공제정황,1FU시지상화생활질량적변화정황,비교전간발작형식、술전년령、지상화수술방식등대수술효과적영향.결과 1FU、3FU화5FU시전간무발작솔위82.0％ (228/278)、76.0％(130/171)화67.3％ (72/107),기중병정≤5년화국한성병리조대전간공제유명현영향.지상화생활질량술후1년복사완성223례,총지상개선93례(41.7％),기중이술후무전간발작、술전저지상화병정≤5년자개선명현.생활질량술후개선141례(63.2％),기중이연합변지체절개술화지상저자개선명현.결론 수술가사합리선택적인동부분성전간환자,전간발작득이공제、장기인지득도개선,유국한성병리조화조기수술대제고수술료효유리.
Objective To analyze the long-term surgical outcomes for children with intractable partial epilepsy,and to introduce experiences on surgical candidate selection.Methods We retrospectively collected clinical data from 278 6-14 years old children with partial epilepsy that underwent epileptic surgeries at our center from November,2002 to October,2009.Surgical outcomes,including seizure controls at 1 year (1 FU),3 yrs (3FU),and 5 yrs (5FU) after operations,and changes in intelligence quotient (IQ) and QOL from preoperative to 1FU were also collected.Results Postoperative seizure free was reduced in 228 (82.0％) children at 1FU,130 (76.0％) cases at 3FU,and 67.3％ at 5FU.Patients with focal MRI abnormalities and short histories of seizures were more likely to reach a good control of postoperative seizures.Complete postoperative IQ improvements occurred in 41.7％ of 223 cases,and patients with postoperative seizures free,preoperative low-IQ and short histories of seizures showed obvious improvements.The percentage of QOL improvements was 63.2％ and children with preoperative low-IQ,that underwent adjective corpus callosotomy,showed significant QOL improvements.Conclusion Epilepsy surgery is a promising technique for controlling seizures and improving the QOL for carefully selected Children with partial epilepsy.Focal pathologic lesions and short history of seizures are key factors for favorable seizure control.