弥漫性轴突损伤后早期并发癫痫患者的预后研究

Prognosis of patients with post-traumatic epilepsy at early time after traumatic diffuse axonal injury

目的研究弥漫性轴突损伤（DAI）早期并发外伤性癫痫患者的预后。方法选择暨南大学第一附属医院神经外科自2000年1月至2011年6月诊治的187例DAI患者，其中早期（伤后2周内）并发外伤性癫痫（PTE）者26例，按1：3的比例选出78例未并发PTE患者作为对照，出院时采用GOS评分和Barthel指数计分评价2组患者的预后和日常生活能力（ADL）。结果并发PTE组和未并发PTE组患者预后、日常生活能力不同，差异均有统计学意义（P〈0．05），由平均秩次判断，早期并发PTE的DAI患者预后差于未并发PTE患者，且存活的患者中，并发PTE的DAI患者日常生活能力低于未并发PTE患者。结论DAI患者早期发作癫痫可显著影响其预后，尤其是重症患者发作癫痫后预后较差，死亡率、致残率显著增加。

Objective To explore the prognosis of patients with post-traumatic epilepsy at early time after traumatic diffuse axonal injury （DAI）. Methods One hundred and eighty-seven patients with DAI, admitted to our hospital from January 2000 to June 2011, were chosen; 26 DAI patients were complicated with post-traumatic epilepsy （PTE） at early time （within 2 weeks of injury）, and the other 78 DAI patients without PTE were chosen as control group. Prognosis and activity of daily living （ADL） of these patients were evaluated with Glasgow Outcome Scale （GOS） and Barthel index. Results Significant differences on prognosis and ADL were noted between patients with and without PTE （P〈 0.05）; the prognosis of DAI patients attacked by PTE at early time was obviously worse than that of the ones who were not. DAI patients with PTE had low ADL than those patients without PTE. Conclusion Attacking by PTE at early time can obviously influence the prognosis of patients with DAI; especially for severe patients, the prognosis is obvious bad, and the mortality and disability rate increase significantly.