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目的探讨大脑半球离断术患儿术前各项临床指标对术后各项神经功能的影响。方法回顾性分析本中心自2014年5月~2015年6月实施大脑半球离断术的患儿33例。收集手术前临床资料。通过门诊及电话随访,以结构化问卷评估术前、术后神经功能状态。采用Fisher精确概率法对术前临床资料与术后功能进行单因素分析。结果 MRI为双侧病变对患儿术后肢体活动能力的预后有重要影响(P<0.001)。患儿年龄影响术后肢体活动能力的预后(以3岁为界定)(P<0.001),年龄小的患儿术后功能恢复较好,年龄对口语能力(以3岁为界)及阅读能力(以10岁为界)也有一定影响(P<0.001)。结论难治性癫痫大脑半球离断术术后神经功能预后与患儿对侧半球病变及患儿年龄有关。
Objective To investigate the effect of preoperative clinical indexes on neurological function in children with hemispheric hemithrombosis after operation. Methods A retrospective analysis of 33 cases of children with hemispheric hemithorax was performed in our center from May 2014 to June 2015. Preoperative clinical data was collected. Through outpatient and telephone follow-up, structured questionnaires were used to evaluate the status of preoperative and postoperative neurological function. Fisher exact test was used to analyze the preoperative clinical data and postoperative function by univariate analysis. Results MRI as a bilateral lesion had a significant effect on the prognosis of postoperative limb mobility in children (P <0.001). The prognosis of children with postoperative limb mobility (defined as 3 years of age) (P <0.001), younger children with functional recovery was better, age of oral ability (at 3 years old) and reading ability (10 years old) also had some effect (P <0.001). Conclusions The prognosis of neurological deficits after intracerebral hemorrhage in patients with refractory epilepsy is related to the contralateral hemispheric lesion and children ’s age.