CAJ | 학술논문

目的：探讨颞叶癫痫患者手术后早期发作的影响因素及其对预后的影响。方法回顾性分析2011年2月至2012年10月首都医科大学附属北京天坛医院神经外科手术治疗的96例颞叶癫痫患者的临床资料，并进行随访，分析癫痫手术后早期发作的影响因素及其对长期预后的影响。结果术后随访所有患者EngelⅠ级73例，EngelⅡ级11例，EngelⅢ级9例，EngelⅣ级3例。15例患者术后出现APOS，随访EngelⅠ级8例，EngelⅡ级3例，EngelⅢ级3例，EngelⅣ级1例。患者的年龄、性别、病程、术前发作频率、发作类型、MRI表现、切除侧别、术后病理等对术后早期发作无影响。出现术后早期发作的患者的癫痫缓解率明显低于无术后早期发作的患者（P＜0．05），惯常发作的患者的癫痫缓解率明显低于非惯常发作的患者（P＜0．05）。结论颞叶癫痫患者术后早期发作的出现提示预后不良，发作形式表现为惯常发作的患者更容易出现癫痫复发。
목적：탐토섭협전간환자수술후조기발작적영향인소급기대예후적영향。방법회고성분석2011년2월지2012년10월수도의과대학부속북경천단의원신경외과수술치료적96례섭협전간환자적림상자료，병진행수방，분석전간수술후조기발작적영향인소급기대장기예후적영향。결과술후수방소유환자EngelⅠ급73례，EngelⅡ급11례，EngelⅢ급9례，EngelⅣ급3례。15례환자술후출현APOS，수방EngelⅠ급8례，EngelⅡ급3례，EngelⅢ급3례，EngelⅣ급1례。환자적년령、성별、병정、술전발작빈솔、발작류형、MRI표현、절제측별、술후병리등대술후조기발작무영향。출현술후조기발작적환자적전간완해솔명현저우무술후조기발작적환자（P＜0．05），관상발작적환자적전간완해솔명현저우비관상발작적환자（P＜0．05）。결론섭협전간환자술후조기발작적출현제시예후불량，발작형식표현위관상발작적환자경용역출현전간복발。
Objective To investigate the factors associated with acute postoperative seizures after temporal lobe epilepsy surgery and the prognostic significance of acute postoperative seizures in temporal lobe epilepsy surgery .Methods The clinical data of 96 patients with temporal lobe epilepsy were collected in our hospital from February 2011 to October 2012 were analyzed retrospectively .The patients were followed up .The factors associated with acute postoperative seizures after temporal lobe epilepsy surgery and the prognostic significance of acute postoperative seizures were analyzed .Results Of 96 patients ,the following up showed that according to Engel classification , 73 belonged in gradeⅠ, 11 in gradeⅡ,9 in grade Ⅲand 3 in grade Ⅳ3.Of 15 patients had acute postoperative seizures , according to Engel classification ,8 belonged in gradeⅠ,3 in gradeⅡ,3 in gradeⅢand 1 in gradeⅣ. The factors such as age at onset ,gender,duration of seizures, seizure frequency, seizure types,MRI manifestation,side of resection,pathology had no effect on the occurrence of acute postoperative seizures . Patients with acute postoperative seizures had worse prognosis compared with patients without acute postoperative seizures(P<0.05).Patients who had acute postoperative seizures similar to preo-perative habitual seizures were less likely to have an excellent outcome than patients whose acute postoperative seizures were not similar to preoperative habitual seizures (P<0.05).Conclusion Acute postoperative seizures after temporal lobe epilepsy surgery predicts bad prognosis .Patients who had acute postoperative seizures similar to preoperative habitual seizures were more likely to have seizure recurrence .