改良多处软脑膜下横纤维切断术在功能区癫痫手术中的应用

Improved multiple subpial transection in the surgery of functional region intractable epilepsy

目的:研究多处软脑膜下横纤维切断术(multiple subpial transection,MST)治疗痫灶位于功能区的顽固性癫痫的疗效和安全性。方法:选择2006年1月至2008年12月癫痫手术患者,对其中152例采用改良MST方法进行联合手术,观察手术并发症并随访手术疗效。结果:全部患者随访1～3年,癫痫发作完全控制者104例(68.4%),明显减少23例(15.1%),减少19例(12.5%),无效6例(4.0%)。所有病例均无永久性功能损害。结论:MST联合其他术式可提高手术疗效。

Objective To investigate the efficacy and security of multiple subpial transection （MST） on epileptogenic lesions located in functional areas in patients with intractable epilepsy. Methods Improved MST was performed in 152 patients with intractable epilepsy from January 2006 to December 2008, and then after operation, the complications and the efficacy were observed. Results All the patients were followed up for 1 to 3 years. Complete control of seizure was obtained in 104 cases （68.4 %）, significant reduction in 23 cases （15.1 %）, reduction in 19 cases （12.5 %） and no change in 6 cases （4.0 %）. No permanent functional defects were found in any patients. Conclusion Improved MST is an effective and secure approach to the surgical treatment for intractable epilepsy.