颅脑外伤术后癫痫的预防

Precautions for epilepsy followed by brain injury operation

目的为颅脑外伤术后癫痫的早期预防和治疗提供依据。方法回顾性分析166例颅脑损伤行开颅手术患者的临床资料,重点分析显微开颅手术、人工硬脑膜的应用以及预防性应用抗癫痫药物等因素与外伤性癫痫的关系。将所选择病例随机分为3组作为研究(每组又分为治疗组和对照组),治疗组分别采用显微镜下开颅手术、人工硬脑膜减张修补硬脑膜缺损、手术后预防性应用抗癫痫药物。对照组采用非显微开颅手术,无硬脑膜修补,术后无系统预防癫痫治疗。结果显微手术组患者癫痫发生率为6.66%,其对照组癫痫发生率为22.50%;硬脑膜修补组癫痫发生率为0,其对照组癫痫发生率为11.36%;药物预防癫痫组癫痫发生率为8.88%,对照组癫痫发生率为25.64%。各组之间对比差异有统计学意义(0.01<P<0.05)。结论显微手术、硬脑膜减张修补以及开颅术后预防性应用抗癫痫药物对减少术后癫痫发作有重要作用。

0bjective To provide the basis for clinical prevent and treatment of post-traunmtie epilepsy （PTE）. Methods The clinical data of 166 patients with craniocerebral injury and operation were retrospectively analyzed. Focuses on the analyzed of microscopic surgical operation, artificial dural application and antiepileptic drugs to prevent traumatic epilepsy happen effect. The patients selected were randomly divided into 3 groups as a case study （each group divided into the treatment group and control group）, The treatment group were used respectively to microscope surgical operation, artificial dural repaired, used drugs to prevent seizures. The control group, adopts the microscopic surgical operation, no dural repaired, no drugs to prevent seizures. Results The microscopic operative patients epilepsy rate of 6.66%, and the control group epilepsy rate of 22.50%. The artificial dural repaired patients epilepsy rate was 0, and the control group epilepsy rate of 11.36%. The application of anti-epilepsy drugs of epilepsy patients was 8.88%, and the control group epilepsy rate of 25.64%. Contrast between groups with a statistical significance （0.01P0.05）. Conclusion The incidence of PTE is significantly reduced by the microsurgery, artificial dural repairs and antiepileptic drug application.