影响手术治疗难治性颞叶癫痫预后的影响因素分析

Analysis of influence factors affecting the prognosis of surgical treatment of refractory temporal lobe epilepsy

目的探讨难治性颞叶癫痫的手术预后及影响因素。方法选择2018年1~12月在我院手术治疗的难治性颞叶癫痫患者90例为研究对象。所有患者均行手术治疗。根据治疗效果分为预后好组(n=65)与预后差组(n=25)。单因素及多因素分析影响患者预后的相关因素。结果(1)90例患者,Ⅰ级24例,Ⅱ级41例,Ⅲ级20例,Ⅳ级5例。其中预后好65例,预后差25例。(2)单因素分析结果显示:脑电图双侧异常放电、术前MRI与V-EEG(视频脑电图)不一致、海马硬化的患者预后较差,差异有统计学意义(P<0.05)。(3)多因素分析结果显示:脑电图双侧异常放电、术前MRI与V-EEG不一致、海马硬化是预后的独立影响因素(P<0.05)。结论手术是治疗难治性颞叶癫痫的较为有效方法,但仍然有部分患者预后效果欠佳。

Objective To explore the prognosis and influence factors of refractory temporal lobe epilepsy.Methods 90 patients with refractory temporal lobe epilepsy who were surgically treated in our hospital from January to December 2018 were selected as the study subjects.All patients underwent surgery.According to the treatment effect,they were divided into the good prognosis group(n=65)and the poor prognosis group(n=25).The univariate and multivariate analysis were used to analyze the relevant factors affecting the prognosis of patients.Results(1)Of the 90 patients,24 were gradeⅠ,41 were gradeⅡ,20 were gradeⅢ,and 5 were gradeⅣ.Among them,65 patients had good prognosis and 25 patients had poor prognosis.(2)Univariate analysis results showed that electroencephalogram(EEG)abnormally discharged on both sides,preoperativemagnetic resonance imaging(MRI)and video electroencephalogram(V-EEG)were inconsistent,and patients with hippocampal sclerosis had a poor prognosis,and the differences were statistically significant(P<0.05).(3)Multivariate analysis showed that EEG abnormally discharged on both sides,preoperative MRI and V-EEG were inconsistent,and hippocampal sclerosis were independent factors affecting prognosis(P<0.05).Conclusion Surgery is a more effective method for the treatment of refractory temporal lobe epilepsy,but there are still some patients with poor prognosis.