大脑半球多脑叶离断术治疗难治性癫痫的疗效
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首都卫生发展科研专项项目(首发2016-1-2011)


Multi-lobe disconnection of cerebral hemisphere for refractory epilepsy: a follow up study
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    目的 探讨大脑半球多脑叶离断术治疗难治性癫痫的手术经验及疗效。方法 回顾性 分析2013 年4 月—2017 年7 月北京功能神经外科研究所采用大脑半球多脑叶离断术治疗难治性癫痫患 者共22例,介绍手术方式,观察术后病理及疗效,记录并发症情况。结果 Engel Ⅰ级患者15例(占68%), Engel Ⅱ级患者6例(占27%),Engel Ⅲ级患者1例(占5%)。术后出现肢体功能障碍较术前加重的患者4 例, 1 例患者出现颅内感染,无一例出现含铁血黄素沉积症。结论 大脑半球多脑叶离断术治疗半球病变 导致的难治性癫痫有较好的疗效,尤其适合那些运动、感觉、语言功能仍然存留在患侧的难治性癫痫患者。

    Abstract:

    Objective To investigate the experience and efficacy of multi-lobe disconnection of cerebral hemisphere in refractory epilepsy. Methods A retrospective analysis was carried out in 22 patients with refractory epilepsy who underwent multi-lobe disconnection of cerebral hemisphere at Beijing Institute of Functional Neurosurgery from April 2013 to July 2017. The retrospective analysis included the introduction of operative method, the postoperative pathology and curative effect, and the complication records. Results During the follow up, 15 cases were in Engel Ⅰ( 68%), 6 in Engel Ⅱ( 27%), 1 in Engel Ⅲ( 5%). There were four patients of significant exacerbation of hemiplegia postoperatively, one patient of intracranial infection. There was no superficial cerebral hemosiderosis. Conclusions The multi-lobe disconnection of cerebral hemisphere can effectively treat the patients with refractory epilepsy caused by hemispheric lesions. This surgery is particularly indicated to the patients with hemispheric lesion, but without the deficit of the motor, sensory and language functions of the hemisphere.

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闫晓明 马凯 张希 高润石 张国君.大脑半球多脑叶离断术治疗难治性癫痫的疗效[J].神经疾病与精神卫生,2018,18(7):
DOI :10.3969/j. issn.1009-6574.2018.07.003.

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  • 在线发布日期: 2018-10-29