在长期相关瘤 (LEATs) 中,我们是否必须在手术后继续服用抗发作药物?
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Kavadisseril Vivekanandan Vysakha1, Kshiteeja Jain1, Jayakumari Nandana1
1R. Madhavan Nayar Centre for Comprehensive Epilepsy Care, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala 695011, India.
在长期相关瘤 (LEATs) 的切除手术后,抗发作药物 (ASM) 撤销在约一半的患者中是成功的. 手术前的普遍性预测了复发,指导了手术后的ASM管理.
科学领域:
- 神经外科 神经外科
- 发病学 (Epileptology) 是一个专业的学科.
- 在瘤学瘤学.
背景情况:
- 长期相关瘤 (LEATs) 通常存在于耐药性.
- 切除性手术是LEATs的主要治疗选择,旨在控制和改善生活质量.
- 手术后的抗发作药物 (ASM) 管理对于长期结果至关重要.
研究的目的:
- 确定LEAT患者在切除手术后成功停止抗发作药物 (ASM) 治疗的比率.
- 为了确定发作复发和ASM戒断成功的预测因素.
- 为了告知ASM管理策略,为LEATs进行后续调整.
主要方法:
- 对123名患者的前性存档数据的回顾性分析,这些患者因ASM耐药性而接受LEAT切除.
- 对手术后的ASM形状和发作复发的评估,在至少2年的随访时间内进行.
- 统计分析包括单变数和多变数后勤回归,以及Kaplan-Meier曲线来评估ASM自由概率.
主要成果:
- 在82.9%的患者中,试图停止ASM,而47.1%的患者在逐渐减少期间经历了发作的复发.
- 在平均6.1年的随访期内,58.5%的患者无发作,53人实现了完全无ASM状态.
- 在手术后10年,ASM无病的累积概率达到59%;手术前的二次通用性预测复发.
结论:
- 对LEATs的切除手术允许在约一半的患者中成功停止ASM治疗.
- 手术前的二次全般性发作是术后发作复发的重要预测因素.
- 完全切除MRI并不能预测发作的复发,强调了临床发作史在ASM管理决策中的重要性.
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