前颞叶切除术后癫痫患者记忆功能的改变及影响因素的分析

Memory function of change in patients with epilepsy after anterior temporal lobectomy and influencing factors

目的:观察前颞叶切除术对癫痫患者记忆改变的作用,并分析影响因素。方法:48例癫痫患者行前颞叶切除术,术后随访1年。采用临床记忆量表,分别在术前1周、术后2周和术后6月进行3次测评。结果:随访1年内,EngleⅠ级38例(79.1%),Ⅱ级6例(12.5%),Ⅲ级3例(6.3%),Ⅳ级1例(2.1%)。术后2周,患者的记忆功能有明显的减退;至术后6月,记忆功能又有所恢复,和术前1周水平相当。而有海马硬化者、优势半球侧手术者、术后疗效差者记忆功能下降较为明显。结论:前颞叶切除术后2周,癫痫患者记忆水平有所下降,其后又逐渐恢复。海马硬化、优势半球侧手术、术后疗效差是其可能的危险因素。

Objective： To observe the memory functional change in patients with epilepsy after anterior temporal lobectomy, and to analyze the influencing factors. Methods： 48 patients with epilepsy undergoing anterior temporal lobectomy were enroll in this study, and followed up for 1 year. Clinical Memory Scale was used to assess the memory function at 1 week before operation, 2nd week and the 6th month after the operation, respectively. Results： In the 1 year follow-up, 38 patients were graded as Engle I, 6 patients, as Engle 1] , 3 patients, as Engle DI, and 1 patients as Engle IV. Two weeks after operation, the memory function in patients significantly reduced; six months after operation, the memory function resorted, to the same level as that 1 week before operation. And patients with hippocampal sclerosis, opera- tion at dominant hemisphere side, and the poor prognosis had more noticeable memory function decline. Conclusion： The memory function decline at 2 weeks after anterior temporal lobectomy for patients with epilepsy, then restored gradually. Hippocampal sclerosis, operation at dominant hemisphere side, poor prognosis may be the risk factors.