CAJ | 학술논문

目的探讨迷走神经刺激术治疗药物难治性癫痫的方法及效果. 方法回顾性分析上海交通大学医学院附属仁济医院神经外科自2007年1月至2011年1月收治的14例药物难治性、全身性癫痫患者临床资料,其中脑炎后继发癫痫6例,外伤后继发癫痫3例,原因不明5例,所有患者均行左侧迷走神经刺激术治疗.术后3周内开机,初始刺激参数为:刺激电流0.25 mA,频率30 Hz,刺激时间30 s,间歇时间5 min,脉宽500 μs.刺激电流强度以0.25 mA为一调整单位逐渐递增,并综合其他参数调控以到达满意疗效. 结果随访3月以上,14例患者术后发作频率平均减少63.6％,其中3例发作频率减少＜50％,11例发作频率减少≥50％,6例发作频率减少＞80％,2例发作停止.5例患者使用磁铁后发作控制得到改善. 结论迷走神经刺激术是一种治疗药物难治性癫痫有效、安全的方法,对全身性癫痫发作患者同样有效.
목적 탐토미주신경자격술치료약물난치성전간적방법급효과. 방법 회고성분석상해교통대학의학원부속인제의원신경외과자2007년1월지2011년1월수치적14례약물난치성、전신성전간환자림상자료,기중뇌염후계발전간6례,외상후계발전간3례,원인불명5례,소유환자균행좌측미주신경자격술치료.술후3주내개궤,초시자격삼수위:자격전류0.25 mA,빈솔30 Hz,자격시간30 s,간헐시간5 min,맥관500 μs.자격전류강도이0.25 mA위일조정단위축점체증,병종합기타삼수조공이도체만의료효. 결과 수방3월이상,14례환자술후발작빈솔평균감소63.6％,기중3례발작빈솔감소＜50％,11례발작빈솔감소≥50％,6례발작빈솔감소＞80％,2례발작정지.5례환자사용자철후발작공제득도개선. 결론 미주신경자격술시일충치료약물난치성전간유효、안전적방법,대전신성전간발작환자동양유효.
Objective To explore the effectiveness and surgical procedures of vagus nerve stimulation (VNS) therapy in patients with drug-resistant epilepsy.Methods Fourteen patients with drug-resistant epilepsy,admitted to our hospital from January 2007 to January 2011,including 6 with epilepsy after cephalitis,3 with epilepsy after head trauma and 5 with idiopathic epilepsy,were chosen in our study; their clinical data were retrospectively analyzed.VNS was performed in all the patients; the initial programming settings were as follows:output current 0.25 mA,frequency 30 Hz,pluse width 500 μs,ON 30 s and OFF 5 min.The optimum settings for each patient should balance the goals of maximizing efficacy,minimizing side effects,and preserving better life.Results The patients experienced a median seizure frequency reduction of 63.6％ after 6-44 months of VNS therapy,including 3 patients having ＜50％ seizure reduction,11 (78.6％) having ＞or=50％ seizure reduction,6 (42.3％)having ＞80％ seizure reduction,and 2 (14.3％) having seizure free.Seizure termination or seizure diminution was reported in 5 (35.7％) patients after using the magnet.Conclusion VNS is a safe and effective therapy and could improve the quality of life in patients with drug-resistant epilepsy; VNS is also effective for patients with symptomatic generalized epilepsy.