癫痫手术后短期内癫痫发作病因分析及临床意义

The Analysis of Etiology and Significance of Acute Postoperative Seizure Following Epilepsy Surgery

目的:研究癫痫手术后短期癫痫发作的原因以及对预后的判断价值。方法:回顾性分析73例患者资料,将抗癫痫药物使用情况、以及是否颞叶癫痫、是否由肿瘤引起的癫痫、是否外伤性癫痫发作作为危险因素与术后短期癫痫发作进行Logistic回归模型分析。并对所有患者进行了12个月以上的随访。手术后短期癫痫发作与患者术后长期控制结果进行χ2检验。结果:19例患者发生APOSs。手术后抗癫痫药物使用不合理可能是APOSs独立的危险因素。癫痫手术患者出现APOSs组与未出现APOSs组在术后随访的癫痫Enge分级评分中无统计学差异。结论:抗癫痫药物的使用不当可能是手术后短期癫痫发作的主要原因之一。癫痫手术后APOSs的出现不能预测患者的长期预后情况。

Objective： The goals of this study were to analyze the etiology and significance of acute post operative seizures. Methods ： Seventy - three Ppatients who underwent surgery for the relief of medicall intractable epilepsy at West China Hospital between 2000 and 2004 with a minimum of 12 months follow - up were studied. The use of anticonvulsant medication, temporal epilepsy, tumorous epilepsy, traumatic epilepsy significant factors were evaluated as risk factoes, and these risk factors were subjected to logistic regression analysis. The Enge scale of patients who had A_POSs and those without APOSs were subjected to Chi - Square Tests. Results： The Nineteen patients experienced APOSs. The logistic regression analysis revealed that abuse of anticon- vulsant medication ,night be significantly associated with the occurrence of APOSs （ P = 0.004）. For Enge scale of patients, the Chi - Square Tests analysis revealed that no difference was found betteen patients who suffered from APOSs and those without an APOSs （ P = 0.231 ）, Conclusions： These data suggested that anticanvulsant medication ,night be the main risk factor for APOSs. No evidence supported the idea that APOSs was an important factor for prediction of long - term seizure control.