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目的:探讨难治性颞叶癫痫的手术配合要点。方法:对20例难治性颞叶癫痫患者应用视频脑电监护系统、术中采用皮层电极、深部电极监测确定致痫灶,若为颞叶内侧结构局限性放电、不伴有其他结构异常,采用选择性海马-杏仁核切除术,其余患者采用经典的前颞叶切除术。结果:术后随访1a,EngleⅠ级15例,Ⅱ级3例,Ⅲ级2例,患者生活质量改善。结论:前颞叶切除术和选择性海马-杏仁核切除术是安全、有效的治疗难治性颞叶癫痫的方法,严格的护理配合是保证手术成功的关键。
Objective: To investigate the surgical coordination of intractable temporal lobe epilepsy. Methods: Video EEG monitoring system was applied to 20 patients with intractable temporal lobe epilepsy. Cortical electrodes and deep electrode monitoring were used to determine the epileptogenic zone. If the internal structure of the temporal lobe was locally discharged without other structural abnormalities, Selective hippocampus-appendectomy was used, and the remaining patients underwent classic anterior temporal lobectomy. Results: All patients were followed up for 1 year, 15 cases were EngleⅠ, 3 cases were Ⅱ and 2 cases were Ⅲ. The quality of life was improved. CONCLUSION: Anterior temporal lobectomy and selective hippocampus-appendectomy are safe and effective methods for the treatment of intractable temporal lobe epilepsy. Strict nursing cooperation is the key to successful operation.