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目的总结手术治疗Rasmussen’s脑炎的早期疗效。方法回顾性分析9例患者的临床资料并系统随访10-30个月。结果经过综合评估,6例行大脑半球切除术,2例行颅内电极脑电图监测后“tailor”式切除联合功能区致痫皮质电凝热灼术,1例行多脑叶切除术。在随访期间,癫痫发作完全消失者3例、偶有发作者2例、发作减轻者3例、1例无缓解。术后早期5例出现肌力下降、4例无变化。经过康复治疗后,肢体功能好转6例,神经心理功能改善8例。结论手术治疗Rasmussen’s脑炎,不仅能有效控制或减轻癫痫发作,还能改善患者的神经心理功能。其早期疗效值得肯定。
Objective To summarize the early effect of surgical treatment of Rasmussen’s encephalitis. Methods The clinical data of 9 patients were retrospectively analyzed and followed up systematically for 10-30 months. Results After comprehensive evaluation, 6 cases underwent hemispherectomy and 2 cases underwent monitoring of “tailor” excision combined with functional epilepsy induced epileptize cortical electrocautery cautery in 2 cases. One case underwent multi-lobectomy Surgery. During the follow-up period, there were 3 cases of complete disappearance of seizures, 2 cases of occasional attack, 3 cases of exacerbations and 1 case of remission. Early postoperative 5 cases of decreased muscle strength, 4 cases no change. After rehabilitation, limb function improved in 6 cases, improved neuropsychological function in 8 cases. Conclusion Surgical treatment of Rasmussen’s encephalitis can not only effectively control or relieve seizures, but also improve neuropsychological function in patients. Its early effect is worthy of recognition.