迷走神经刺激术治疗难治性癫痫(附25例报告)

Vagus nerve stimulation for intractable epilepsy( report of 25 cases)

目的研究迷走神经刺激术治疗难治性癫痫的适应证选择、手术方法、术后程控及疗效。方法 2009年11月-2016年7月清华大学玉泉医院癫痫中心对25例难治性癫痫患者行迷走神经刺激术,术后给予程控管理控制癫痫发作;并通过随访回顾性分析术后疗效。结果术后随访患者4个月-7年,其中癫痫发作频率减少达McHughⅠ级6例、Ⅱ级12例、Ⅲ级4例、Ⅳ级1例、Ⅴ级2例。手术前后癫痫发作频率对比,差异有统计学意义（P〈0.05）。结论迷走神经刺激术作为一种安全有效的辅助治疗难治性癫痫的方法,其治疗效果可以随着参数的调整和时间延长而增强,并可以一定程度改善患者的认知行为和生活质量。

Objective To explore the curative effects of vagus nerve stimulation（ VNS） on intractable epilepsy. Methods The clinical data of 25 patients with intractable epilepsy,who were treated by VNS in our center from November 2009 to July 2016,were analyzed retrospectively.Results The follow up from 4 months to7 years showed that of 25 patients,6（ 24%） belonged in MCHugh grade Ⅰ,12（ 48%） in grade Ⅱ,4（ 16%） in grade Ⅲ and 3（ 12%） in grades Ⅳ - Ⅴ.Conclusions VNS is a safe and effective method to treat the intractable epilepsy. VNS may make seizure frequency reduce over 50% in more than 60% patients with intractable epilepsy. The present results suggested that the curative effect is correlated with the stimulation parameter and duration.