显微外科治疗颞叶癫痫的疗效分析

Analysis of Curative Effects of Microsurgery on Intractable Temporal Epilepsy

目的评价外科治疗难治性颞叶癫痫的手术疗效。方法回顾性分析外科的治疗236例难治性颞叶癫痫患者的临床资料。结果随访2～15年,疗效按Engel的标准评定,236例中,Ⅰ级159例(67.4%),Ⅱ级34例(14.4%),Ⅲ级25例(10.6%),Ⅳ级18例(7.6%),总有效率为92.4%,效果优良率为81.8%。无严重并发症及手术死亡病例。结论应用显微外科技术治疗难治性颞叶癫痫是一种安全、有效的方法;对致痫灶的精确定位和正确处理及减少并发症是提高疗效的关键。

Objective To evaluate the curative effect of microsurgery on intraetable temporal epilepsy. Methods The clinical data of 236 patients with intractable temporal epilepsy, who underwent microsurgery for the inti-actable temporal epilepsy from August, 1990 to July, 2006 in our hospital, were analyzed retrospectively. All the patients were followed up from 2 to 15 years. Results According Engel grade of curative effect on the epilepsy, of 236 patients, 159 （67.4%） had an Engel grade Ⅰ outcome after surgery, 34 （14.4%） Engel grade Ⅱ, 25 （10.6%） Engel grade Ⅲ, and 18 （7.6%） Engel grade Ⅳ. The total effective rate was 92.4%. There were not severe complications and no patients died in 236 patients. Conclusions Microsurgery is a safe and effective method to treat intractable temporal epilepsy. Accurate location of epileptogenic loci and positive prevention and correct treatment of complications are very important to enhancement of curative effect of microsurgery on the intractable temporal epilepsy.