CAJ | 학술논문

目的：探讨胼胝体全段切开治疗难治性癫?的安全性与治疗效果。方法：回顾性分析我科2010年1月～2013年3月期间20例难治性癫?患者行胼胝体全段切开术治疗，其中 Lennox‐Gastaut综合征（LGS ）12例，West综合征（又称婴儿痉挛症）8例。术后随访6个月～3年。结果：4例（20％）癫?发作完全消失；8例（40％）癫?发作次数显著减少；5例（25％）癫?发作程度减轻；2例（10％）无明显改善；1例（5％）发作略有加重；无死亡病例。4例患者出现不同程度的手术后并发症；缄默3例，头皮感染1例。其中3例患者分别在出院时和出院后3个月内痊愈，1例患者仍遗留缄默。手术后疗效以改良Engel标准评判，优良率为65％。结论：对于部分性发作癫?患者，最可靠的治疗方法是致?灶的切除，但对于全面性发作的病人，其致?区往往比较广泛而无法切除，胼胝体切开可以阻断两侧大脑半球?样放电的传播，从而可以减少发作频率、减轻发作程度和改变发作形式，提高治疗效果。
목적：탐토변지체전단절개치료난치성전?적안전성여치료효과。방법：회고성분석아과2010년1월～2013년3월기간20례난치성전?환자행변지체전단절개술치료，기중 Lennox‐Gastaut종합정（LGS ）12례，West종합정（우칭영인경련증）8례。술후수방6개월～3년。결과：4례（20％）전?발작완전소실；8례（40％）전?발작차수현저감소；5례（25％）전?발작정도감경；2례（10％）무명현개선；1례（5％）발작략유가중；무사망병례。4례환자출현불동정도적수술후병발증；함묵3례，두피감염1례。기중3례환자분별재출원시화출원후3개월내전유，1례환자잉유류함묵。수술후료효이개량Engel표준평판，우량솔위65％。결론：대우부분성발작전?환자，최가고적치료방법시치?조적절제，단대우전면성발작적병인，기치?구왕왕비교엄범이무법절제，변지체절개가이조단량측대뇌반구?양방전적전파，종이가이감소발작빈솔、감경발작정도화개변발작형식，제고치료효과。
Objective:To approach the features of total corpus callosotomy for patients with intrac‐table epilepsy ,and to explore the safety of the procedure and observe it's efficacy in controlling the seizure of epileptic encephalopathy .Methods :20 cases were operated with total corpus callosotomy including 12 cases with LGS and 8 cases with WS .Their conditions were retrospectively studied during 6~36 months follow‐up .Results:4 cases (20% )were free from seizure ;significant reduction of seizure attack in 8 (40% );reduction of seizure attack in 5 cases (25% );no change in 2(10% );aggravation of seizure attack in 1(5% );no death cases .According to the assessment of curative effect based on Engel standard affer operation ,fineness rate was 65% .Conclusion:The most dependable surgical operation method for intrac‐table epilepsy is ermoved of epileptogenic focus but for comprehensive patients ,the epileptogenic focus is usually more extensive and can't be cut off .Total corpus callosotomy can stop epileptic electricity of dis‐semination of two‐side hemispheres reduce epileptic seizure frequency and ease the degree or change the forms of seizure and make the cure effect of total corpus callosotomy of satisfactory .