颞叶癫癎患者前颞叶切除术后短期认知变化的侧别及性别差异

Short-term effects of postoperative cognition and gender differences in refractoy temporal lobe epilepsy

目的：对行一侧标准前颞叶切除术（ATL）的颞叶癫癎（ATL）患者在术前及术后开展神经心理测试，并进行统计学分析，旨在分析行一侧ATL不同性别患者在认知功能上的短期影响及变化。方法：选择一侧ATL的颞叶癫癎患者42例，进行术前和术后6个月的神经心理测试，采用临床记忆测验和多维神经心理测验。结果：①行一侧ATL的42例患者术后6个月神经心理测验分数与术前比较，记忆水平降低，语音加工及语义理解能力提高；②在术前，行左侧ATL的患者记忆商低于行右侧 ATL患者；在术后，行不同侧别ATL的患者语音加工及语义理解能力均有提高，但差异无显著性；③男性与女性患者在术后记忆商数均有下降，但男性患者无论在术前还是术后的记忆商数均较女性低；不同性别患者术后语音加工和语义理解能力等方面均有提高，但女性在术后的语义理解分数的提高上较男性更显著。结论：在侧别方面，行左侧ATL较右侧切除的病人，术后记忆功能在短期内有降低；在性别方面，女性无论是在记忆还是语音加工、语义理解能力等方面均比男性佳。

Objective：A considerble part of refractory epilepsy is temporal lobe epilepsy（TLE） .An‐terior temporal lobectomy（ATL） is an importan tramtment of it .The efficacy of ATL is up to 70% -80% ,but one‐sided ATL and the cogntive fuction of gender differece were rarely in clina throgh postoper‐ative and postoperative including clinical memory tets and multidimentsional‐neruopsychological measure‐ment ,the study was aimd at statistical analysis of the short‐term effects of ATL on cognitive function and gender difference .Methods：42 patients with one‐sided ATL at this center ,21 male cases and 22 female ca‐ses（male 24 .23 ± 7 .67 ,female 24 .45 ± 9 .35） .Preoperative and pstoperative examinations were carried out for six months respetively with psychological testing ,including clinical memory tests and multidimen‐sional neuropsychological tests（phonemic processing and semantic comprehension） .Results：1 .For the 42 cases with of one‐sided ATL ,their memory lowered ,voice processing and semantic understanding ability raised .2 .Compared with cases with left side ATL ,for patients with right side ATL the preoperative memory quotient was reduced;yee both patients’ postoperative scores increased in speech processing and semantic understanding ability .3 .The memory quotient values of both male and female patients declined after operation ,but preoperative and postoperative memory quotients of male cases were lower than those of female cases ,yet the postoperative phonemic processing and semantic comprehension ability of all cases increased ,and women’s semantic understanding of postoperative scores increased more than men’s .Con‐clusion：Compared with cases with left side ATL ,postoperative memory Quotient of patients with right side ATL is reduced in the short term observation value;in terms of gender ,both memory and phonemic processing and semantic comprehension ability of women are higher than those of men ,for womes’s mem‐ory quotient declined lower than men’s and their phonemic processing and semantic comprehension func‐tions improved significantly than men’s .