矢状窦、大脑镰旁脑膜瘤手术与继发性癫痫的控制及防治

发布时间：2018-02-10 20:11

本文关键词： 矢状窦大脑镰旁脑膜瘤癫痫治疗　出处：《国际神经病学神经外科学杂志》2017年02期 　论文类型：期刊论文

【摘要】：目的分析继发性癫痫在矢状窦、大脑镰旁脑膜瘤中的发生机制及危害,探讨如何预防和减少肿瘤相关性癫痫的发生。方法回顾性分析自2011年3月~2016年6月我科住院手术的23例窦、镰旁脑膜瘤患者的临床资料,通过对比不同肿瘤特征的手术方法及继发性癫痫的发生情况。结果全部病例均手术治疗,其中肿瘤I级切除19例,II级切除4例。术前有癫痫发作7例,术后24小时癫痫发作1例,术后24小时~7天发生癫痫5例,2年内新增癫痫病例5例,3例部分运动性失语,4例出现对侧不同程度肢体偏瘫,卡方检验比较得出瘤周有无水肿(p=0.007)及术前有无使用抗癫痫药物(p=0.027)对术后继发性癫痫的发生具有影响。结论肿瘤相关性癫痫对窦、镰旁脑膜瘤患者术后危害极大,术前有癫痫病史的患者在围手术期应积极给予抗癫痫治疗,对于有明显瘤周水肿、术中脑挫伤、回流静脉损伤等高危患者术后应积极给予药物预防治疗。
[Abstract]:Objective to analyze the secondary epilepsy in the sagittal sinus and falx meningioma in the pathogenesis and harm, discuss how to prevent and reduce the occurrence of tumor related epilepsy. Methods a retrospective analysis from March 2011 ~2016 year in June 23 cases of sinus surgery hospitalized in our department, the clinical data of falx meningioma patients, through comparison of different surgical methods tumor characteristics and secondary epilepsy. Results all cases were treated by operation, of which I grade tumor resection in 19 cases, 4 cases of grade II resection before operation. 7 cases of epilepsy, 1 cases of epilepsy after 24 hours, 24 hours after ~7 days in 5 cases of epilepsy, 2 years new epilepsy in 5 cases, 3 cases of motor aphasia, 4 cases of contralateral hemiplegia in different degrees, the chi square test comparing peritumoral edema (p=0.007) and whether preoperative use of antiepileptic drugs (p=0.027) on postoperative epilepsy had influence Conclusion tumor related epilepsy of sinus falx meningioma patients with great harm, preoperative history of epilepsy should give positive antiepileptic therapy in the perioperative period, with obvious peritumoral edema, cerebral contusion, vein injury and other high-risk patients should receive active drug prevention and treatment.

【作者单位】：安徽省马鞍山市中心医院神经外科;
【分类号】：R739.45

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