Xu Xinke,Li Junliang,Chen Cheng,et al.Surgical treatment for intractable epilepsy in infants[J].Journal of Clinical Pediatric Surgery,2019,18(05):409-412.[doi:10.3969/j.issn.1671-6353.2019.05.014]
婴幼儿难治性癫痫外科治疗探讨
- Title:
- Surgical treatment for intractable epilepsy in infants
- Keywords:
- Epilepsy/SU; Treatment Outcome; Infant; Child
- 分类号:
- R729;R742.1
- 摘要:
- 目的 总结婴幼儿难治性癫痫的外科治疗效果。方法 以2014年10月至2016年10月在广州市妇女儿童医疗中心神经外科住院并接受外科手术治疗的28例婴幼儿难治性癫痫患儿为研究对象，并对其病程、发作类型、影像学及脑电图结果、手术方式、术后癫痫控制情况、并发症进行回顾性分析。结果 28例婴幼儿难治性癫痫患儿均进行严格的术前评估，根据患儿具体情况采用不同的外科手术方式。其中接受局灶性病变切除术者23例，接受功能性大脑半球切除术者4例，接受迷走神经刺激器植入术者1例。术后随访6个月至2年，按Engel预后分级判断疗效，其中Ⅰ级23例（82.15%），Ⅱ级2例（7.14%），Ⅲ级1例（3.57%），死亡2例（7.14%）。结论 外科手术是婴幼儿难治性癫痫的有效治疗方法之一，详尽的术前评估、选择合适的手术方式及娴熟的显微外科技术是治疗成功的关键。
- Abstract:
- Objective To explore the surgical outcomes of intractable epilepsy in infants.Methods Retrospective analyses were performed for 28 infants with intractable epilepsy operated between 2014 to 2016.Through chart review,clinical course,seizure type,radiography,electroencephalography,surgical procedures,seizure-free status and surgical complications were examined.Engel classification was employed for evaluating the clinical outcomes.Results Twenty-eight patients underwent different surgical procedures according to preoperative assessments.Focal leison resection (n=23),functional hemispherectomy (n=4) and vagus nerve stimulator implantation (n=1) were performed.The follow-up period was 6-24 months.According to the Engel’s classification,the outcomes were Engel Ⅰ(n=23,82.15%),Engel Ⅱ(n=2,7.14%) and Engel Ⅲ (n=1,3.57%).There were two deaths (7.14%).Conclusion Surgical treatment is effective for intractable epilepsy in infants.And thorough preoperative assesments,appropriate surgical procedures and skilled microsurgical techniques are vital for surgical success.
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备注/Memo
收稿日期:2018-01-13。
通讯作者:李方成,Email:sjwklfc@126.com