[1]林久銮,周文静,孙朝晖.半球性病变癫痫外科术式选择策略[J].临床神经外科杂志,2015,(03):163-167.

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半球性病变癫痫外科术式选择策略()

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《临床神经外科杂志》[ISSN:1672-7770/CN:32-1727/R]

Title:: The strategy of selection of operation ways for hemispheric epilepsy

摘要:: 目的：研究半球性病变癫痫不同手术方式选择的策略。方法：分析清华大学玉泉医院癫痫中心90例半球性病变癫痫采用的手术方式及决定或影响手术方式的因素。结果：90例共采用4种手术方式，其中74例采用改良解剖大脑半球切除、10例采用保留运动区的大脑半球切除、3例采用分次的半球切除、3例采用半球离断。其中改良的解剖大脑半球切除中有62采用经纵裂胼胝体侧脑室入路切除方式、12采用经中央沟侧脑室前后分块切除。病例随访8年到3个月，癫痫控制情况根据Engle评分，结果Ⅰ级73例、Ⅱ12例；Ⅲ级5例。结论：综合考量磁共振病变特点、症状学及脑电图定侧定位和脑功能评价结果，采用不同的手术方式，能够取得很好的癫痫控制效果、最大程度的保护脑功能、减少创伤、降低术后并发症。

Abstract:: Objective: To study the different operation way for hemispheric epilepsy.Methods: The different operation way and procedure of the 90 patients who underwent hemispherectomy for refractory epilepsy were analyzed in the retrospective study. Results: Among the 90 patients, 4 operation ways were selected,the modified hemispherectomy were used for 74 cases, the hemisphrectomy with motor cortex preserved were used in 10 patients,the hemisphrectomy by two times were used in 3 patients,and the hemisphretomy were used in 3 patients.The modified hemispherectomy were performed via longitudinal fissure callosal and ventricle approach in 62 patients,and were performed by two block removal via central sulcus ventricle approach in 12 patinets. After follow-up ranged from 3 months to 8 years. According Engel’s classification, 73 were classified as Engel class Ⅰ, Engel class Ⅱ was found in 12 patients and Engel class Ⅲ in 5 patients. Conclusion: The selection of suitable of the operation way taking account of the features of the lesion, the EEG,the symptoms and brain functons for hemispheric epilepsy is important for inhanceing the effect of seizure controls and lowing the operation complications.

更新日期/Last Update: 2015-06-15