手术的长期结果:来自第三级推中心的25年经验
Marco Almeida1,2, Francisco Barros1,2, Inês Cunha1,2
1Referral Center for Refractory Epilepsy, Epilepsy Surgery Program Group - ULS Coimbra, Coimbra, Portugal.
Epileptic disorders : international epilepsy journal with videotape
|September 6, 2025
概括
手术可以导致超过一半的患者长期无发作,特别是左叶手术和手术期间的监测. 大多数患者也可以在成功手术后减少抗发作药物.
科学领域:
- 神经外科
- 病学
- 临床神经学
背景情况:
- 药物耐药性会影响到三分之一的患者,
- 手术的长期结果尚未得到充分研究,很少有超过5年的研究.
研究的目的:
- 分析经过手术的患者的长期 (≥15年) 结果.
- 确定手术后成功控制发作的因素.
主要方法:
- 对 160 名患者的前性收集数据进行了回顾性分析,后续观察时间至少为 15 年.
- 用于抓获自由度评估的恩格尔分类;采用单变量描述性分析和相关性测试.
- 记录了手术细节,病因和手术内皮质谱 (ECOG) 的使用.
主要成果:
- 在15岁的患者中,57. 5%的患者获得了无性发作; 63. 2%的患者经历了罕见的致残性发作.
- 切除性手术 (70%) 是常见的,其中损伤切除和前切除最常见.
- 叶手术,左侧手术,肌肉硬化病因和手术内使用ECOG与更好的结果有关.
结论:
- 在绝大多数患者中,手术可缓解发作.
- 左叶切除与手术期间监测显示有希望的长期结果.
- 转移到专门的中心有助于采取多学科的治疗方法.
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