论文部分内容阅读
目的探讨外科手术治疗半球性癫痫的疗效,评价手术对患者的社会心理及认知功能的影响。方法 93例半球性癫痫患者经过综合评估后行手术治疗,其中Adams’s术式30例,Rasmussen’s术式7例,大脑半球切开术3例,多脑叶切除术24例,多脑叶切除联合胼胝体切开术29例。术后随访2.5年~6年3个月。手术疗效以Engel分级标准判定。结果术后癫痫控制情况:EngelⅠ级43例,Ⅱ级24例,Ⅲ级19例,Ⅳ7例。手术后早期患者的偏瘫无明显加重,肌张力及痉挛状态得到不同程度缓解,辅助系统康复训练后,肢体功能明显改善;高级皮层功能,生活自理能力和社会适应能力得到不同程度的提高。结论手术治疗半球性癫痫不仅可有效控制癫痫发作,患者的言语、肢体运动功能无恶化,神经心理功能和生活质量还有不同程度提高。而上述功能改善程度与年龄呈正相关。
Objective To investigate the efficacy of surgical treatment of hemipheric epilepsy and evaluate the impact of surgery on patients’ social psychology and cognitive function. Methods A total of 93 patients with hemifacial epilepsy were treated with surgery. Among them, 30 were treated with Adams’s procedure, 7 with Rasmussen’s procedure, 3 with hemispherectomy, 24 with multi-lobectomy, and multiple lobectomy combined with corpus callosum Incision in 29 cases. The patients were followed up for 2.5 years to 6 years and 3 months. Surgical efficacy to Engel grading standards. Results Postoperative epilepsy control: Engel Ⅰ 43 cases, Ⅱ 24 cases, Ⅲ 19 cases, Ⅳ 7 cases. The patients with hemiplegia had no obvious aggravation in early postoperative period, and the muscle tension and spasticity were relieved to some extent. After assisted training, the limb function improved significantly. The function of senior cortex, self-care ability and social adaptability were improved to some extent. Conclusion Surgical treatment of hemiparetic epilepsy not only can effectively control seizures, patients’ speech, no deterioration of limb motor function, neuropsychological function and quality of life have increased to varying degrees. The degree of improvement of these functions was positively correlated with age.