联合皮层脑电图治疗难治性癫痫的回顾性分析
发布时间：2018-11-11 13:01
【摘要】：目的：探究难治性癫痫患者的外科治疗手术疗效,并对影响手术疗效的有关因素进行分析,以期得出影响预后的相关因素和控制癫痫发作的最佳治疗计划。方法：随访2009-07/2014-07在新疆医科大学第一附属医院神经外科行癫痫手术治疗的108例,对其病例的病史、影像学检查、电生理监测等结果及其手术方案及术式和预后进行回顾性分析。结果：发病年龄、致痫灶位置与术后患者预后无统计学差异(P0.05)。颞叶内侧癫痫手术效果最佳,患者病理结果与手术预后有统计学差异,胼胝体切除的手术预后最差,海马杏仁核切除术的手术预后最为理想。术中脑电图的变化与手术预后有统计学差异(P0.01),术中棘波数明显减少者手术预后更佳。结论：符合手术指征的癫痫外科患者,需系统评估患者情况,选择合适的手术方案。致痫灶的准确定位,对于癫痫外科治疗的成功至关重要。术中皮层脑电图监测,对于准确切除病灶及致痫灶有指导性作用。
[Abstract]:Objective: to investigate the surgical efficacy of intractable epilepsy patients and analyze the related factors affecting the outcome of the operation in order to obtain the best treatment plan for the control of epileptic seizures. Methods: one hundred and eight patients with epilepsy treated by neurosurgery in the first affiliated Hospital of Xinjiang Medical University were followed up in 2009-07 / 2014-07. The results of electrophysiological monitoring, surgical procedures, surgical procedures and prognosis were retrospectively analyzed. Results: there was no significant difference in age, location of epileptogenic foci and prognosis of postoperative patients (P 0.05). The result of medial temporal lobe epilepsy was the best. The pathological results were significantly different from the operative prognosis. The prognosis of corpus callosum resection was the worst, and that of hippocampal amygdaloidectomy was the best. The change of electroencephalogram (EEG) was significantly different from the operative prognosis (P0.01). The operative prognosis was better when the number of spikes decreased significantly. Conclusion: patients with epileptic surgery who meet the surgical indications should be evaluated systematically and the appropriate procedure should be selected. Accurate location of epileptogenic foci is crucial to the success of surgical treatment of epilepsy. The monitoring of electrocortical electroencephalogram (EEG) during operation is instructive for accurate excision of lesions and epileptogenic foci.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R742.1
本文编号：2324917
[Abstract]:Objective: to investigate the surgical efficacy of intractable epilepsy patients and analyze the related factors affecting the outcome of the operation in order to obtain the best treatment plan for the control of epileptic seizures. Methods: one hundred and eight patients with epilepsy treated by neurosurgery in the first affiliated Hospital of Xinjiang Medical University were followed up in 2009-07 / 2014-07. The results of electrophysiological monitoring, surgical procedures, surgical procedures and prognosis were retrospectively analyzed. Results: there was no significant difference in age, location of epileptogenic foci and prognosis of postoperative patients (P 0.05). The result of medial temporal lobe epilepsy was the best. The pathological results were significantly different from the operative prognosis. The prognosis of corpus callosum resection was the worst, and that of hippocampal amygdaloidectomy was the best. The change of electroencephalogram (EEG) was significantly different from the operative prognosis (P0.01). The operative prognosis was better when the number of spikes decreased significantly. Conclusion: patients with epileptic surgery who meet the surgical indications should be evaluated systematically and the appropriate procedure should be selected. Accurate location of epileptogenic foci is crucial to the success of surgical treatment of epilepsy. The monitoring of electrocortical electroencephalogram (EEG) during operation is instructive for accurate excision of lesions and epileptogenic foci.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R742.1
【参考文献】
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1 徐波涛;漆松涛;王洪筱;韩慧霞;吕超;王克万;何晓艳;杨开军;;药物难治性癫痫相关局灶性脑皮质发育不良临床分析(附21例报告)[J];中国神经精神疾病杂志;2013年05期
，本文编号：2324917
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