CAJ | 학술논문

目的：报告顽固性颞叶癫痫行前颞叶切除的并发症，探讨术后并发症的发生率、原因和预防措施。方法顽固性颞叶癫痫患者行前颞叶切除，术后出现急性脑梗死伴颅内感染、硬膜外血肿、轻偏瘫等情况，采取抗炎、抗脑水肿、抗凝治疗及清除血肿等治疗。结果首例病人卡马西平治疗随访1年，癫痫发作消失；第2例随访7年，癫痫发作消失；第3例癫痫消失，但残留轻偏瘫，后渐恢复，遗留左手指屈伸力差。结论血肿和感染是术后最频发的并发症，偏瘫（操作性偏瘫）是最严重的神经并发症，手术时损伤脉络膜前动脉是最可能导致偏瘫的原因。
목적：보고완고성섭협전간행전섭협절제적병발증，탐토술후병발증적발생솔、원인화예방조시。방법완고성섭협전간환자행전섭협절제，술후출현급성뇌경사반로내감염、경막외혈종、경편탄등정황，채취항염、항뇌수종、항응치료급청제혈종등치료。결과수례병인잡마서평치료수방1년，전간발작소실；제2례수방7년，전간발작소실；제3례전간소실，단잔류경편탄，후점회복，유류좌수지굴신력차。결론혈종화감염시술후최빈발적병발증，편탄（조작성편탄）시최엄중적신경병발증，수술시손상맥락막전동맥시최가능도치편탄적원인。
Objective To report the complications of anterior temporal lobectomy for patients with refractory temporal epilepsy,and to explore the incidence of postoperative complications,reason and preventive measures. Methods The patients were presented with postoperative acute inflammatory cerebral infarction associated with intracranial infection,extradural hematoma and contralateral hemiplegia.After a combined effective anti-inflammatory, dehydration and anticoagulant therapy.Results The first patient had remained seizure-free on carbamazepine for one year.During the seven-year follow-up,the second patient was seizure-free and he was back to work with antiepileptic drugs discontinuing.During the seven-year follow-up,the third patient was also seizure-free and his left hemiparesis was recovered.There was no epileptiform waves appeared in EEG in the absence of antiepileptic drugs.However,the flexion extension force of his left fingers was poor.Conclusion Hematoma and infection are the most common postoperative complications of anterior temporal lobectomy.Hemiparesis(manipulation hemiplegia),however,is the most frequent and the most serious neurological complication.It is now general accepted that anterior choroidal artery injury during the operation is the most likely reason leading to hemiparesis.