胼胝体切开治疗顽固性癫痫(附102例病例分析)

Corpus Callosum Cutting Treatment on Patients with Intractable Epilepsy (with 102 Cases Analysis)

目的：评估胼胝体切开术治疗顽固性癫痫的有效性及安全性。方法：选取102例顽固性癫痫患者,包括全面性强直发作（GTS）、全面性强直-阵挛发作（GTCS）及失张力发作（AS）三种典型发作类型,全部行胼胝体切开术进行治疗,术后患者继续服用常规抗癫痫药物,术后随访6个月~4年,评价患者的癫痫控制状况及是否出现手术并发症。结果：恢复效果达到良好以上者共计84例,占接受该手术患者总数的82.4%,32%行胼胝体切开术的患者出现了并发症,其中1.9%为永久性并发症,无围手术期死亡病例。结论：胼胝体切开术可以有效地减少顽固性癫痫患者的发作频率,虽然具有较大的并发症风险,但对于致痫区广泛并且不能手术切除的顽固性癫痫患者,胼胝体切开术依然是有效而且必要的。

Objective：To evaluate the efficacy and safety of corpus callosotomy （CC） in the patients with refractory seizures. Methods：All 102 patients with refractory seizures underwent a corpus callosotomy （n=31） without other forms of epilepsy surgery, and continued taking regular anti-epileptic drugs.The following up from 12 to 60 months after the surgery was carried by qualified clinicians of neurosurgery, and seizure response and procedure complications were evaluated.Results：84 patients reported a fine-above recovery alter surgery,accounting for 82.4% of the total patients.The risk of complication for corpus callosotomy was 32% （1.9% permanent ） and no people died in perioperative period among patients accepted corpus callosolomy.Conclusion：The corpus callosotomy is effective in reducingg eneralized seizures frequency, but corpus callosotomy is also associated with higher risk of complications, even if these were generally transient.Generally,corpus callosotomy is still effective and necessary for intractable epilepsy patients.