特重型颅脑创伤后继发癫痫患者的预后及生活质量研究

The prognosis and quality of life of special severe craniocerebral injury patients with secondary epilepsy

目的探讨特重型颅脑创伤患者继发癫痫的预后情况以及生活质量情况,以期为临床诊治提供借鉴。方法收集2009年1月~2012年2月在该院住院治疗的特重型颅脑创伤患者105例,根据是否继发癫痫分为观察组和对照组两组,对两组患者的预后以及生活质量情况进行对比分析。结果在所有特重型颅脑损伤患者中共有41例继发癫痫,发生率为39.05%;观察组死亡率56.10%高于对照组的35.94%,两组比较差异有显著性（P〈0.05）,继发癫痫患者的治疗有效率为43.90%;观察组QOL总分（52.9±16.8）明显低于对照组的（66.4±17.9）,两组比较差异有显著性（P〈0.05）;观察组发作担忧（44.6±23.4）、情绪健康（49.6±17.4）、认知功能（50.6±21.4）、社会功能（47.5±20.4）明显低于对照组的（75.1±31.7）、（68.4±13.5）、（61.5±19.8）和（57.1±21.2）,两组比较差异有显著性（P〈0.05）。结论特重型颅脑损伤患者继发癫痫的发生率高,预后差,并且是影响患者生活质量下降的重要因素。

[ Objective ] To investigate the clinical outcomes and the quality of life （QOL） of special severe cranio- cerebral injury patients with secondary epilepsy. [Methods] 105 patients with special severe craniocerebral injury were divided into two groups, including observation group and control group. The clinical outcomes and quality of life were observed. [Results] There were 41 cases with secondary epilepsy in all the special severe craniocerebral injury, the incidence was 39.05%; The mortality rate in observation group was significantly lower than that in control group （P 〈0.05）. The total effective rate of the treatment group was 43.90%, the score of QOL （52.9±16.8）, seizure worry （44.6±23.4）, emotional function （49.6±17.4）, cognitive function （50.6±21.4） and social functions （47.5±20.4） in the observation group was significantly lower than that in control group （P 〈0.05）. [ Conclusion ] The cases with sec- ondary epilepsy in the special severe craniocerebral injury has high incidence and poor prognosis,which was the main factor that lower the quality of life of patients.