[1]华刚,谭红平,张立民,等.低级别胶质瘤及混合神经元胶质瘤相关癫痫的手术治疗策略[J].临床神经外科杂志,2019,16(06):465-471.[doi:10.3969/j.issn.1672-7770.2019.06.002]
 HUA Gang,TAN Hong-ping,ZHANG Li-min,et al.Surgical strategy for low-grade glioma and mixed neuron glioma-related epilepsy[J].Journal of Clinical Neurosurgery,2019,16(06):465-471.[doi:10.3969/j.issn.1672-7770.2019.06.002]
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低级别胶质瘤及混合神经元胶质瘤相关癫痫的手术治疗策略()
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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06期
页码:
465-471
栏目:
专家共识
出版日期:
2019-12-03

文章信息/Info

Title:
Surgical strategy for low-grade glioma and mixed neuron glioma-related epilepsy
作者:
华刚谭红平张立民李少春陈俊喜朱丹
510510 广州,广东三九脑科医院癫痫中心癫痫外科
Author(s):
HUA Gang TAN Hong-ping ZHANG Li-min et al.
Department of Epilepsy Surgery, Guangdong Sanjiu Brain Hospital, Guangzhou 510510, China
关键词:
低级别胶质瘤神经元混合胶质瘤术中皮层电极监测SEEG监测
Keywords:
low-grade glioma mixed neuron glioma intraoperative cortical electrode monitoring SEEG monitoring
分类号:
R742.1;R739.41
DOI:
10.3969/j.issn.1672-7770.2019.06.002
文献标志码:
A
摘要:
【摘要】目的探讨低级别胶质瘤及混合神经元胶质瘤相关癫痫的手术治疗策略。方法回顾性分析广东三九脑科医院癫痫中心2011年—2017年手术治疗的171例低级别胶质瘤及混合神经元胶质瘤相关癫痫患者的临床资料;并复习相关文献。结果本组患者中,169例患者在无创Ⅰ期评估后,行术中皮层电极监测下手术治疗;2例患者通过立体脑电图(stereo-EEG,SEEG)监测技术明确致痫灶范围后,行开颅手术治疗。肿瘤性病变累及功能区的患者在术中唤醒配合下进行手术。其中肿瘤次全切者32例,仅行肿瘤全切除者6例,其余患者的切除范围均较肿瘤病变扩大。所有患者术后均未出现神经功能障碍、颅内感染、血肿等手术并发症;并常规服用抗痫药物。经过1~7年的随访,其中Engle Ⅰ级者149例、Engle Ⅱ级19例、Engle Ⅲ级1例、Engle Ⅳ级2例。结论低级别胶质瘤及神经元混合胶质瘤相关癫痫的手术治疗是癫痫外科治疗的重要组成部分。应按照癫痫外科的术前评估流程进行合理细致的评估,根据具体情况进行个体化的治疗策略可以改善患者的预后,更好地提高患者的生活质量。
Abstract:
Abstract: ObjectiveTo explore the surgical strategies for low-grade glioma and mixed neuron glioma-related epilepsy. MethodsThe clinical data of 171 patients with low-grade glioma and mixed neuronal glioma-related epilepsy who underwent surgery from 2011 to 2017 in Department of Epilepsy Surgery, Guangdong Sanjiu Brain Hospital were analyzed retrospectively. And the related literatures were reviewed. Results169 patients underwent non-invasive stage I assessment and obtained resections under the intraoperative cortical electrode monitoring. 2 patients underwent SEEG monitoring to determine the extent of epileptogenic zone and then received craniotomy. Patients with neoplastic lesions involving the functional area underwent surgery with intraoperative awakening. 32 cases were lesion subtotal resection, and only 6 were lesion total resection. The remaining patients had a larger resection range than the tumor lesions. All patients had no surgical complications such as neurological dysfunction, intracranial infection, and hematoma. Every patient took anti-epileptic drugs after surgery. After 1 to 7 years of follow-up, 149 patients obtained Engle Ⅰ level, 19 obtained Engle Ⅱ level, 1 obtained Engle Ⅲ level, 2 obtained Engle Ⅳ level. ConclusionsSurgical treatment of low-grade glioma and neuronal mixed glioma-related epilepsy is an important part of epilepsy surgery. It should be evaluated reasonably according to the preoperative evaluation procedure of epilepsy surgery, and individualized surgical strategy can improve the patients’ prognosis and quality of life according to the specific situation.

相似文献/References:

[1]段光辉,魏洪涛.低级别胶质瘤中癫痫的治疗进展[J].临床神经外科杂志,2015,(05):396.

更新日期/Last Update: 2019-12-10