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儿童癫痫的外科治疗探讨

Pediatric intractable epilepsy surgery

摘要:

目的 探讨儿童顽固性癫痫的外科治疗措施.方法 回顾性分析2004年4月至2006年4月期间的96例患儿的临床资料和外科治疗方案.结果 经神经内外科、儿科等多科室评估,78例采用切除性手术、17例采用姑息性手术、1例采用立体定向毁损手术.手术疗效以Engel标准评判.在14~26个月的随访期间,Engel Ⅰ级者58例、Ⅱ级者26例、Ⅲ、Ⅳ级者12例,总有效率87.5%(Engel Ⅰ级、Ⅱ级患者所占比例);81例患儿的神经心理功能有不同程度改善;22例患儿出现术后并发症,在随访期间15例完全恢复,1例死亡.结论 儿童顽固性癫痫多为症状性癫痫和特殊癫痫综合征,手术可有效控制或缓解癫痫发作并能部分改善患儿神经心理功能.

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abstracts:

Objective To explore the strategy of pediatric intractable epilepsy surgery.Methods The clinical data of 96 pediatric cases with intractable epilepsy and epilepsy syndromes underwent surgical treatment from April 2004 to April 2006 were retrospectively analyzed.Results The surgical treatments were performed based on the results of comprehensive data from neurological,neurosurgical and pediatric departments.Among of them,78 cases were performed with curative procedure,17 cases with palliative procedure and 1 case with stereotactic damage procedure.The surgical effect was judged with Engel's standard,58 cases had no seizure during 14 to 26 months follow-up,26 cases had significantly improved in seizure control and the total efficiency was 87.5%.81 cases had improvements in neuropsychological tests.22 cases had postoperative complications such as neurodysfunctions and 15 cases were gradually recovered after the period of follow-up ended,1 case died of CSF over drainage after operation 3 months.Conclusions Pediatric patients with symptomatic epilepsy and epilepsy syndromes are suitable to surgical treatment,the results are satisfactory in seizure control and neuropsychological function tests.

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作者: 李云林 [1] 栾国明 [2] 周健 [2] 鲍明 [2]
第一作者: 李云林
期刊: 《中华外科杂志》2008年46卷3期 210-212页 MEDLINEISTICPKUCSCD
分类号: R6
栏目名称: 论著
DOI: 10.3321/j.issn:0529-5815.2008.03.017
发布时间: 2008-06-04
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