迷走神经刺激术与胼胝体切开术治疗药物难治性癫痫的效果研究

Study on the Effect of Vagus Nerve Stimulation and Corpus Callosotomy in the Treatment of Drug-resistant Epilepsy

目的:比较迷走神经刺激术(VNS)与胼胝体切开术(CC)对治疗药物难治性癫痫(DRE)的效果。方法:选取2015年1月-2020年1月本院收治的85例DRE患者,将其按照手术方式分为A组(n=41)和B组(n=44)。A组采用VNS治疗,B组采用CC治疗。比较两组手术指标、并发症发生情况,比较术后3、6个月的总有效率及术前和术后3、6个月的QOLIE-31评分。结果:A组手术时长、住院康复时间均短于B组,术中失血量少于B组,差异均有统计学意义(P<0.05)。两组术后3、6个月的总有效率比较,差异均无统计学意义(P>0.05)。两组术后血管损伤、神经损伤、术区感染以及尿失禁发生率比较,差异均无统计学意义(P>0.05)。术前,两组QOLIE-31评分比较,差异均无统计学意义(P>0.05);术后3、6个月,A组QOLIE-31评分均高于B组,差异均有统计学意义(P<0.05)。结论:VNS治疗DRE患者的术中失血量更少,对早日康复有积极促进作用,且并发症发生率无明显提高,可改善患者的生活质量。

Objective:To compare the influence of vagal nerve stimulation (VNS) and corpus callosotomy (CC) in the treatment of Drug-resistant epilepsy (DRE).Method:A total of 85 patients with DRE admitted to the hospital from January 2015 to January 2020 were selected,and they were divided into group A (n=41) and group B (n=44) according to surgical treatment methods.The group A was treated with VNS treatment,while the group B was treated with CC treatment.The surgical indicators and the incidence of complications were compared between two groups,the total effective rate 3 and 6 months after surgery and the QOLIE-31 score before and 3 and 6 months after surgery were compared between two groups.Result:The surgical duration and hospitalization recovery time of the group A were shorter than that of the group B,and the intraoperative blood loss of the group A was less than that of the group B,the differences were statistically significant (P<0.05).3 and 6 months after surgery,there were no significant differences in the total effective rates between two groups (P>0.05).There were no significant differences in the incidences of postoperative vascular injury,nerve injury,operative area infection and urinary incontinence between two groups (P>0.05).Before surgery,there was no significant difference in QOLIE-31 scores between two groups (P>0.05).3 and 6 months after surgery,QOLIE-31 scores of the group A were higher than those of the group B,the differences were statistically significant (P<0.05).Conclusion:VNS treatment of DRE patients with less intraoperative blood loss,has a positive role in promoting early recovery,and the incidence of complications did not significantly increase,can improve the quality of life of patients.