重型颅脑外伤术后癫痫发作58例临床分析

Postoperative Epilepsy of Severe Craniocerebral Injury: Retrospective Analysis of 58 Cases

目的探讨重型颅脑外伤术后癫痫发作的原因,预防及治疗应注意的问题。方法对476例重型脑外伤手术后并发癫痫发作的58例患者进行分析,重点对术后的预防用药、易致癫痫发作原因及再次手术问题进行总结。结果476例颅脑外伤术后并发癫痫发作58例,占12.2%,并发癫痫病例大多药物治疗效果好,对难治性癫痫药物无法控制的5例病例经再次手术均取得满意疗效。结论对重型脑外伤手术中的正确处理以及术后恰当的预防性用药等可以降低术后癫痫的发病率、减轻癫痫发作程度。

Objective To investigate the cause for epilepsy in patients with severe traumatic brain injury after operation, and to discuss its prevention and treatment. Methods The data of 58 patients with epilepsy after operation due to severe traumatic brain injury （STBI） from a total of 476 traumatic brain injury patients were retrospectively summarized and studied, and the emphasis on prevention, the cause of seizure and reoperation were discussed. Results Fifty-eight of the 476 patients （ 12.2% ） suffered postoperative seizures. Most of them got good results after drug treatment. Five patients with intractable seizures that could not be controlled by drugs were treated by operation and satisfactory results were achieved. Conclusion The correct manipulation in operation for STBI and appropriate medication after operation could not only decrease the incidence of epilepsy in the inpatients with STBI but relieve the degree of seizure as well.