摘要
目的探讨运用多脑叶切除联合多软膜下横纤维切断术(MST)或／和胼胝体部分切开术治疗脑电图 提示为单侧半球为主的多脑叶或半球弥漫性癎灶患者的手术疗效。方法 回顾性总结、分析采用多脑叶切除联合 MST或／和胼胝体部分切开术所治疗的具有半球(为主)多脑叶或半球弥漫性癎灶的18例重型顽固性癫癎患者。结 果本组术后随访1～5年,平均2年。疗效按Engel的标准评定,I级(术后即无癫癎发作)11例;Ⅱ级(每年仅1 ～2次发作)3例;Ⅲ级(发作频率减少75％以上)2例;Ⅳ级2例,总有效率16／18;效果优良14／18,无于术死亡。结 论采用多脑叶切除联合其他术式治疗具有半球(为主)多脑叶或弥漫性癎灶的重型顽固性癫癎具有疗效好、并发 症相对较少等优点,比大脑半球切除术具有更广泛的适应证。
Objective To evaluate the effect of muhilobar resection in combination with multiple subpial transection （MST） or/and corpus callosotomy on hemispheric - dominant muhilobar or diffuse epileptogenic focus. Methods The operation results of 18 patients with severe intractable epilepsy were retrospectively analyzed. Results All patients were fol- lowed up one to five years, mean two years. Postoperative seizure outcome was classified according to Engel＇s four categories by an epileptogogist. Class Ⅰ（ seizure- free） indicates an absence of seizure activity postoperafively in 11 cases . Class Ⅱ indicates rare seizures ; that is ,a few seizures in a year in 3 cases. Class Ⅲ indicates worthwhile improvement ,meaning at least a 75% improvement in seizure frequency eomparted with preoperative status in 2 cases. Class Ⅳ denotes on worthwhile improvement in 2 patients. Gross efficiency rate is 16/18 of patients, conspicuous efficiency rate is 14/18 of patients, No death. Conclusions Muhilobar resection in combination with other operations is a suitable way to treat hemispheric - dominant muhilobar or diffuse intractable epilepsy owing to good results and less complication, and can widely used in contrast to hemispherectomy.
出处
《中国神经精神疾病杂志》
CAS
CSCD
北大核心
2005年第5期347-350,共4页
Chinese Journal of Nervous and Mental Diseases
关键词
多脑叶切除
多软膜下横纤维切断术
胼胝体切开
弥漫性癎灶
顽固性癫癎
Multilobar resection
Multiple subpial transection （MST）
Corpus callosotomy
Diffuse epileptogenic
Focus intractable epilepsy
