CAJ | 학술논문

目的总结结节性硬化症所致癫痫患者的术前评估及手术方式,观察术后疗效.方法回顾性分析北京三博脑科医院2004年6月至2011年6月手术治疗的20例结节性硬化症患者临床资料并系统随访1～5年.结果经过综合评估,单纯致痫结节切除术8例；电极植入后致痫结节切除术1例；脑叶切除术4例；致痫结节切除+致痫皮层热灼术2例；脑叶切除+离断术1例；迷走神经刺激术2例；胼胝体全段切开术2例.术后随访Engel Ⅰ级11例,Ⅱ级2例,Ⅲ级5例,Ⅳ级2例,有效率达90％ (18/20).结论经过精确术前评估,选择合适的手术方式,可以有效地控制或减轻结节性硬化引起的癫痫发作.
목적 총결결절성경화증소치전간환자적술전평고급수술방식,관찰술후료효.방법 회고성분석북경삼박뇌과의원2004년6월지2011년6월수술치료적20례결절성경화증환자림상자료병계통수방1～5년.결과 경과종합평고,단순치간결절절제술8례；전겁식입후치간결절절제술1례；뇌협절제술4례；치간결절절제+치간피층열작술2례；뇌협절제+리단술1례；미주신경자격술2례；변지체전단절개술2례.술후수방Engel Ⅰ급11례,Ⅱ급2례,Ⅲ급5례,Ⅳ급2례,유효솔체90％ (18/20).결론 경과정학술전평고,선택합괄적수술방식,가이유효지공제혹감경결절성경화인기적전간발작.
Objective To summary preoperative assessment and surgical approaches of tuberous sclerosis complex (TSC) patients.Methods We retrospectively analyzed the clinical data of 20 cases with epilepsy induced by TSC from June 2004 to June 2011 in Beijing Sanbo Brain Hospital.All the patients were fellowed up 1-5 years.Results Different surgical approaches had been made based on the pre-operative assessment.The pure nodules resection were made of 8 patients.The nodules resection were made after subdural electrodes implantation of 1 patient.The lobotomy was made of 4 patients.The nodule resection combined bipolar electro-coagulation on functional cortex (BCFC) were made of 2 patients.The lobotomy combined disarticulation was made of 1 patient.VNS was made of 2 patients.Corpus callosotomy was made of 2 patients.All the patients were fellowed up 1-5 years,averaged 2.9 years.Engel Ⅰ,in 11 patients ;Engel Ⅱ,in 2 patients; Engel Ⅲ,in 5 patients; Engel Ⅳ,in 2 patients.The effective rate was 90％(18/20).Conclusions By the accurate assessments,the epilepsy seizure which is induced by TSC can been controlled or reduced with different surgical approaches.