痫灶切除方式对顽固性癫痫手术疗效的影响

The relationship between degrees of resection of the epileptic foci and the effect in intractable epilepsy

目的 :探讨影响手术治疗顽固性癫痫疗效的因素。研究痫灶切除方式、病灶存在与否与疗效的关系。方法 :对 1992年以来术后随访 3年以上的 5 1例顽固性癫痫进行回顾性分析。采取Ridit分析 ,比较痫灶完全切除组 (2 0例 )与痫灶不完全切除组 (31例 )、占位组 (2 8例 )与非占位组 (2 3例 )的疗效。结果 :全组显效率达 88.2 3%。1 痫灶完全切除组的疗效较痫灶不完全切除组好 (P <0 .0 1) ;2 占位组与非占位组疗效无差别 (P >0 .0 5 )。结论 :痫灶切除程度对顽固性癫痫手术疗效有重要影响 ,有无占位性病灶对疗效影响不大 ,进一步说明了病灶与痫灶是二个不同的概念。把痫灶切除与否作为影响疗效的主要因素更具合理性。

Objective:The purpose of this paper was to evaluate the factors in the surgical treatment of intractable epilepsy and to study the correlation of varying degrees of resection of the epileptic foci and the surgical outcomes.Method:A total of 51 patients has been treated with operation since 1992.These cases,followed for 3 years postoperatively,were analyzed retrospectively by divided into two groups on the basis of degrees of resection of the epileptic foci,two groups on pathologic findings.The outcomes of two groups were compared with each other by Ridit analysis.Results: Total or marked relief of symptoms has been obtained in 88.23% of the patients.The effectiveness of the complete resection group of mass-leision (20 cases ) and that of incomplete resection group (31 cases) significant difference ( P <0.05). But the outcomes of the group of mass-leision (28 cases ) and the group (23 cases) have not difference( P >0.05).Conclusions: Degrees of resection of the epileptic foci is a more important indicator to evaluate the surgical outcomes of intractable epilepsy.It is further confirmed that they are different conceptions between “epileptic focus”and “pathologic lession”.