论文部分内容阅读
目的探讨皮层脑电图(electrocorticography,ECoG)在颅内肿瘤切除前后的变化特点及其对术后癫痫的预测价值。方法选择95例颅内肿瘤患者,于病灶切除前后进行ECoG监测,根据ECoG上多棘波密度、波幅变化分为术后痫性放电增多组(A组)、不变组(B组)及减少组(C组)。术后癫痫根据发生时间分为早期癫痫(术后1周内)与晚期癫痫(1周后)。随访4年,比较各组术后癫痫的发生率。结果95例颅内肿瘤患者病灶切除后ECoG显示A组13例(13.68%),B组37例(38.95%),C组45例(47.37%)。95例中术后早期癫痫32例(33.68%),分别为A组8/13例(61.54%)、B组13/37例(35.14%)、C组11/45例(24.44%),3组间比较差异有统计学意义(χ2=6.2,P<0.05);晚期癫痫17例(17.89%),A、B、C组分别为1/13例(7.69%)、7/37例(18.92%)、9/45例(20.00%),3组间比较差异无统计学意义(χ2=1.04,P>0.05)。32例早期癫痫中有7例(21.88%)出现晚期癫痫,63例术后无早期癫痫的病例中有10例(15.87%)出现晚期癫痫,二者比较差异无统计学意义(χ2=0.93,P>0.05)。结论颅内肿瘤切除前后的ECoG变化有助于预测术后早期癫痫。
Objective To investigate the changes of cortical electrocorticography (ECoG) before and after intracranial tumor resection and its predictive value for postoperative epilepsy. Methods Ninety-five patients with intracranial tumors were enrolled in this study. ECoG monitoring was performed before and after lesion excision. According to the spike density and amplitude of ECoG, the patients were divided into two groups: group A, group B, Group (Group C). Postoperative epilepsy according to the time of onset is divided into early epilepsy (within 1 week after surgery) and advanced epilepsy (after 1 week). After 4 years of follow-up, the incidences of postoperative epilepsy in each group were compared. Results ECoG in 95 patients with intracranial tumors showed 13 cases (13.68%) in group A, 37 cases (38.95%) in group B and 45 cases (47.37%) in group C. There were 32 (33.68%) cases of early postoperative epilepsy in group A, 8/13 (61.54%) in group A, 13/37 (35.14%) in group B and 11/45 (24.44%) in group C There were significant differences between the two groups (χ2 = 6.2, P <0.05); 17 cases (17.89%) of advanced epilepsy, 1/13 cases (7.69%), 7/37 cases %), 9/45 cases (20.00%). There was no significant difference among the three groups (χ2 = 1.04, P> 0.05). There were 7 cases (21.88%) of advanced epilepsy in 32 cases, and 10 cases (15.87%) in 63 cases of early epilepsy without advanced epilepsy. There was no significant difference between the two groups (χ2 = 0.93, P> 0.05). Conclusion ECoG changes before and after intracranial tumor resection are helpful to predict early postoperative epilepsy.