伽玛刀与手术在颞叶癫痫治疗中的临床疗效比较

Comparison of clinical effects of gamma knife and surgical treatment on temporal lobe epilepsy

目的:探究伽玛刀与手术治疗颞叶癫痫的临床疗效。方法:选取接受颞叶癫痫治疗的138例患者为研究对象,并以治疗方法差异为依据,将其中99例接受手术方案实施治疗的患者作为手术组,将其中接受伽马刀方案治疗的39例患者作为伽马刀组,对比两组的临床疗效。结果:术后随访5年,手术组患者中40例为EngelⅠ级、42例为EngelⅡ级、9例EngelⅢ级、8例EngelⅣ级;而伽马刀组中8例为EngelⅠ级、9例为EngelⅡ级、10例EngelⅢ级、12例EngelⅣ级,手术组治疗效果明显优于伽马刀组(P<0.05);手术组并发症发生率为29.29%(29/99),明显高于伽马刀组的12.82%(5/39)(P<0.05)。结论:对颞叶癫痫患者采取手术治疗的效果要优于伽玛刀治疗,但手术治疗并发症发生率较高;而伽马刀治疗后的并发症少,但会受到靶区体积大小的限制,临床可针对部分接受伽马刀治疗后失败的患者,采取二次手术实施治疗。

Objective： To explore clinical effects of gamma knife and surgical treatment on temporal lobe epilepsy. Methods：138 patients receiving temporal lobe epilepsy treatment were selected as the research subjects. According to the difference of treatment methods,99 of them were treated with surgeries as surgical group,and 39 patients received gamma knife treatment as gamma knife group. The clinical effects of the two groups were compared. Results： All the patients were followed-up for 5 years. In the surgical group,there were 40 cases of Engel Ⅰ,42 of Engel Ⅱ,9 of Engel Ⅲ and 8 of Engel Ⅳ; while in the gamma knife group,there were8 cases of Engel Ⅰ,9 of Engel Ⅱ,10 of Engel Ⅲ and 12 of Engel Ⅳ. The effects of the surgical group were significantly superior to those of the gamma knife group（ P〈0.05）. The complication incidence in the gamma knife group（ 12.82%,5/39） was much less than that in the surgical group（ 29.29%,29/99）（ P〈0.05）. Conclusions： For the patients with temporal lobe epilepsy,the effects of the surgical treatment are superior to those of the gamma knife treatment,but the complication incidence is higher. However,there are fewer complications after the gamma knife treatment,but it will be limited by the size of the target area. So,for the patients whose gamma knife treatment has failed,a second surgery could be performed.