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1、維普資訊http://www.cqvip.com2007年6月第23卷第6題Chin上!!』豎!:!墊::魚·445·.臨床論著.小兒難治性癲癇綜合征的外科治療劉仕勇安寧楊輝楊梅華黃婷劉立紅【摘要】目的總結(jié)外科手術(shù)治療27例小兒難治性癲癇綜合征病人的經(jīng)驗(yàn)。方法術(shù)前評(píng)估和術(shù)中腦電檢查顯示為局灶性改變者行致癇灶切除、腦葉切除或多軟膜下橫纖維切斷(MST)。檢查提示一側(cè)半球?yàn)橹鞫嘣钚愿淖冋撸g(shù)中行多腦葉切除聯(lián)合MST或(和)胼胝體部分切開。結(jié)果本組隨訪1-8年,平均4.5年。27例病人中有l(wèi)4例獲得I級(jí)(Enge1分級(jí)),8例獲得Ⅱ
2、級(jí),3例為Ⅲ級(jí)。平均智商(IQ)從術(shù)前的61.4分提高到75.0分,癲癇病程和術(shù)前藥物難治的時(shí)問越短,智商改善越明顯。本組4例病人出現(xiàn)暫時(shí)性的并發(fā)癥,無手術(shù)死亡。結(jié)論對(duì)小兒難治性癲癇綜合征進(jìn)行早期外科干預(yù),可以有效地控制癲癇發(fā)作、改善智力損害和避免生活殘疾。I關(guān)鍵詞】難治性癲癇;癲癇綜合征;外科治療;多腦葉切除;兒童癲癇SurgeryofpediatricpatientswithintractableepilepsysyndromesLIUShi—yong,ANNing,YANGHui,YANGMeihua,ttUANGTin
3、g,Li—hong.DepartmentofNeurosurgery,XinqiaoHospital,theThirdMilitaryMedictdUuni~ersity,Chongqing400037,ChinaCorrespondingauthor:ANNing,Email:anning19641111@163.corn【Abstract】ObjectiveThedrug—resistanceinsomeepilepsysyndromesthatbegininthechildhoodalepredictableandsho
4、wthetolerancetoepilepsysurgery,andsurgeryof27pediatricpatientswithintractableepilepticsyndromesbetween1997-2004werereviewed.MethotisResectionofepileptogenicfociorlobe,and/ormultiplesubpialtransection(MST)wasfollowedwhenafocalepilepticdischargewasindicatedaccordingIo
5、preoperativeevaluationandEcoG,butmuhiloharresectionwithMSTor/andcorpuscallosotomywerechosentodealwithhemisphericmultipleepilepticloci.ResultsAtfollow—up,onaverage4,5yearsaftersurgery,fourteenof27patients(51.9%)hadanEngelClassIoutcomeaftersurgeryandanadditionaleightp
6、atients(29.6%)hadrateseizure(EngelClasslI),andthreepatientshadadecreaseinseizurefrequency(EngelClassII).MeanIQimprovedfrom61.4to75.0,andmorelQimprovementfoHowedthepatientswithshorterseizurehistoryanddrugresistancetime.Temporarycomplicationswereobservedinfourpatients
7、andtherewerenodeath.ConclusionEarlysurgicalinterventioninintractablepediatricepilepsysyndromesprovidesthegoodopportunitytocontroltheseizure,preventirreversibleimpairmentofintelligenceandavoidalifetimeofdisability.【Keywords】Intractableepilepsy;Eplepsysyndromes;Surger
8、y;Multilobarresection;Pediatrieepilepsy近十多年來,人們已逐漸認(rèn)識(shí)到許多癲癇綜合1997年6月至2004年6月對(duì)27例兒童期的藥物難征病人從發(fā)病起就是藥物難治性癲癇,目前報(bào)道的治性癲癇綜合征病人施行了外科手術(shù)治療,現(xiàn)報(bào)告主要包括嬰兒早期癲