[1]霍俊杰,朱海涛,杨露,等.海马硬化合并局灶性皮质发育不良致难治性颞叶癫痫手术预后的影响因素[J].临床神经外科杂志,2019,16(4):298-302.[doi:10.3969/j.issn.1672-7770.2019.04.005]
 HUO Jun-jie,ZHU Hai-tao,YANG Lu,et al.Analysis on prognostic factors in surgery for refractory temporal lobe epilepsy induced by hippocampal sclerosis with focal cortical dysplasia[J].Journal of Clinical Neurosurgery,2019,16(4):298-302.[doi:10.3969/j.issn.1672-7770.2019.04.005]
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海马硬化合并局灶性皮质发育不良致难治性颞叶癫痫手术预后的影响因素()
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《临床神经外科杂志》[ISSN:1672-7770/CN:32-1727/R]

卷:
16
期数:
2019年第4期
页码:
298-302
栏目:
癫痫专题
出版日期:
2019-08-15

文章信息/Info

Title:
Analysis on prognostic factors in surgery for refractory temporal lobe epilepsy induced by hippocampal sclerosis with focal cortical dysplasia
作者:
霍俊杰朱海涛杨露徐宏浩张锐
210029 南京,南京医科大学附属脑科医院功能神经外科
Author(s):
HUO Jun-jie ZHU Hai-tao YANG Lu et al.
Department of Functional Neurosurgery, Brain Hospital Affiliated to Nanjing Medical University, Nanjing 210029, China
关键词:
颞叶癫痫海马硬化局灶性皮质发育不良手术预后
Keywords:
epilepsy hippocampal sclerosis focal cortical dysplasia operation prognosis
分类号:
R742.1
DOI:
10.3969/j.issn.1672-7770.2019.04.005
文献标志码:
A
摘要:
【摘要】目的 探讨影响海马硬化(hippocampal sclerosis,HS)合并局灶性皮质发育不良(focal cortical dysplasia,FCD)双重病理所致难治性颞叶癫痫手术预后的因素。方法回顾性分析45例病理学证实为双重病理(HS合并FCD)致难治性颞叶癫痫手术患者的临床资料。术后随访1~5年,将随访结果进行Engel分级,Engel Ⅰ-Ⅱ级者为治疗有效组,Ⅲ-Ⅳ级者为治疗无效组。应用二元Logistic回归分析影响预后的相关因素。结果术后Engel分级:治疗有效组29例(64.4%),其中Ⅰ级者27例、Ⅱ级者2例;治疗无效组16例(35.6%),其中Ⅲ级者9例、Ⅳ级者7例。二元Logistic回归分析示,病理分型为FCD Ⅲa型(P=0.032,OR=6.098,95% CI=1.167~31.863)和致痫灶是否完全切除(P=0.002,OR=13.487,95% CI=2.574~70.679)对手术预后的影响有统计学意义;而发病年龄、术前发作频率、病程、手术年龄、有无高热惊厥史、头颅MRI是否异常对手术预后的影响均无统计学意义(均P>0.05)。结论病理分型为FCD Ⅲa型、完全切除致痫灶是双重病理(HS合并FCD)所致颞叶癫痫手术预后良好的影响因素。
Abstract:
Abstract: ObjectiveTo study the prognostic factors of surgical operation in patients with refractory temporal lobe epilepsy(TLE) induced by dual pathology of hippocampal sclerosis(HS) with focal cortical dysplasia(FCD). MethodsThe clinical data of 45 patients with refractory TLE induced by pathological proved dual pathology(HS with FCD) were analyzed retrospectively. The postoperative follow-up ranged from 1 to 5years, according to the follow-up results. Engel classⅠ-Ⅱwere taken as the effective treatment group and Engel class Ⅲ-Ⅳ were taken as the ineffective treatment group. The binary logistic regression analysis was used to investigate the factors influencing the prognosis of surgery. Results29 (29/45) patients were in the effective treatment group. Among them, 27 were Engel class Ⅰand 2 were Engel class Ⅱ. 16(16/45) patients were in the ineffective treatment group. Among them, 9 were Engel class Ⅲ and 7 were Engel class Ⅳ. Binary logistic regression analysis showed that histopathological subtypes were FCDⅢa or not (χ2=4.593, P=0.032, OR=6.098, 95% CI=1.167-31.863) and complete resection of epileptogenic area or not(χ2=9.477, P=0.002, OR=13.487, 95% CI=2.574-70.679) were statistically significant. Onset age, preoperative seizure frequency, course of onset, age at operation, having a history of febrile seizure or not and positive or not on MRI were not statistically significant(P>0.05). ConclusionThe operative prognoses of the patients with TLE induced by dual pathology(HS with FCD) are associated with histopathological subtypes, complete resection of epileptogenic area.

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更新日期/Last Update: 2019-08-01