迷走神经刺激治疗癫痫的实验和临床研究

Experimental and clinical studies of epileptic treatment with vagus nerve stimulation

目的通过动物实验，探讨迷走神经刺激治疗癫痫的有效性和最佳刺激参数，并对临床上癫痫持续状态病人进行疗效研究。方法应用士的宁制成动物癫痫模型，手术后直接刺激左侧迷走神经，应用不同的刺激参数组合进行刺激。对临床上癫痫持续状态的病人，经皮间接刺激迷走神经进行疗效观察。结果应用波宽２ｍｓ、频率１００Ｈｚ、电压１０Ｖ的组合参数刺激，全部实验动物的强直性发作立刻得到控制、痫样放电立即消失，脑电图恢复正常。选择病人可以耐受的电压幅度连续电脉冲刺激左侧颈部迷走神经体表投影区，进行经皮间接刺激治疗不同类型癫痫持续状态，结果完全控制率为８３．３％。有效率达１００％。结论刺激左侧迷走神经治疗癫痫和经皮刺激迷走神经治疗癫痫持续状态有效，但刺激参数至关重要。

Objective To investigate the therapeutic effect of epilepsy with vague nerve stimulation and the best simulative parameters through animal experiments,and explore the therapeutic effect of epilepticism of patients in clinic. Methods By preparing epileptic pattern of animals with strychnice,left vagus nerve was stimulated directly with epilepticism in clinic to observe the therapeutic effect with indirect stimulating left vagus nerve through skin. Results The seizure of animals were controlled immediately with stimulative parameters (2 ms100 Hz10 V),and EEG become normal.Selecting the higher voltage that the patient could tolerated stimulated the left vagus of patients.Through projective area of body surface of left vagus nerve in cervical part to different epilepticism.The results showed complete controlled rate83.3%, effective rate 100%. Conclusions To treat epilepsy with stimulating left vagus nerve it was effective to,but the stimulative parameters were most important.