前颞叶切除与选择性海马—杏仁核切除治疗颞叶内侧癫痫的疗效比较

发布时间：2018-05-19 08:25

本文选题：颞叶癫痫 + 前颞叶切除　；参考：《山西医科大学》2014年硕士论文

【摘要】：目的：比较前颞叶切除(ATL)与选择性海马-杏仁核切除(SelAH)治疗颞叶癫痫的手术效果。方法：作者在清华大学玉泉医院癫痫中心进修期间,搜集了2010年1月至2012年6月87例颞叶内侧癫痫手术病例进行回顾性研究,其中62例患者实施了前颞叶切除,另25例患者接受了选择性海马-杏仁核切除。术后疗效的评估参照Engel's评分标准,采用SPSS13.0统计软件进行数据分析。结果：本研究所收集的ATL组和SelAH组的临床病例通过统计学分析,其一般资料：性别比例、手术侧别、平均发病年龄、平均病程及平均手术年龄上并没有显著性差异。术后6个月-3年随访,两种术式预后为Engel I级的比例分别为74.2%、72.0%,差异无统计学意义(P=0.834)。ATL组有18(29.0%)例病人术后出现并发症,SelAH组出现并发症的人数为5(20.0%)例,两组并发症发生率统计学无差异(P=0.748)。结论：1、从本研究术后半年-3年的病例统计结果看,两种术式的Engel I级预后及并发症发生率相近,但是SelAH发生并发症的严重程度高于ATL。2、对于具体不同患者,临床工作中在选择手术方式时不应拘泥于对以上两标准的比较,而是应结合患者病情、手术期望及术者水平等具体情况做个性化治疗方案。
[Abstract]:Aim: to compare the effect of anterior temporal lobectomy (ATL) and selective hippocampal amygdaloidectomy (SelAH) in the treatment of temporal lobe epilepsy. Methods: from January 2010 to June 2012, 87 cases of medial temporal lobe epilepsy were retrospectively studied during the course of further study in the Center of Epilepsy, Yuquan Hospital, Tsinghua University. Among them, 62 cases underwent anterior temporal lobectomy. Another 25 patients underwent selective hippocampal-amygdala resection. The evaluation of postoperative curative effect was carried out with SPSS13.0 statistical software according to Engel's score. Results: there was no significant difference in general data: sex ratio, operative side, mean age of onset, mean course of disease and mean age of operation between ATL group and SelAH group. After 6 months to 3 years follow-up, the ratio of Engel I grade was 74.2 and 72.0, respectively. There were 1829.0 cases of postoperative complications and 50.20% of the patients in SelAH group. There was no statistical difference in the incidence of complications between the two groups (P < 0. 748). Conclusion: from the statistical results of six months to three years after operation in this study, the prognosis and the incidence of complications of Engel I were similar, but the severity of complications in SelAH was higher than that in ATL. 2. In clinical work, we should not stick to the comparison of the above two standards, but should combine the patient's condition, the expectation of operation and the level of the operator to make the individualized treatment plan.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R742.1

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