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目的总结分析青少年儿童Lennox-Gastaut综合征(LGS)手术治疗效果,探讨胼胝体切开术(CCT)用于学龄期儿童LGS的价值。方法回顾性研究2003年2月-2007年1月在本院接受胼胝体切开手术治疗的28例13~18岁的Lennox-Gastaut综合征患者,统计病人的发病、检查及手术治疗情况,并统计术后1年(1FU)和5年(5FU)癫痫控制情况、智商和生活质量的变化情况及影响因素。结果发病年龄平均5.57岁,病程平均9.71年;影像学异常7例(25.0%)。智商测定结果示中重度精神发育迟滞(FIQ≤50)12例(42.86%)。1FU和5FU时无发作者分别为:17.86%(5例)和10.71%(3例)。同时癫痫发作减少≥50%分别为64.28%(18例)和57.14%(16例)。其中1FU和5FU时两组结果差异无统计学意义(P>0.05)。1FU时总智商改善46.43%(13/28),总生活质量改善64.28%(18/28)。智商和生活质量的变化与癫痫控制情况无关。术后早期并发症4例,无远期并发症。结论前部CCT可以明显减少青少年LGS患者的癫痫发作,提高QOL和IQ水平,且具有很好的安全性。因此前部CCT可以用于慎重选择的LGS的手术治疗。
Objective To summarize the surgical treatment of Lennox-Gastaut syndrome (LGS) in adolescent children and investigate the value of corpus callosotomy (CCT) for LGS in school-age children. Methods A retrospective study of 28 patients with Lennox-Gastaut syndrome aged 13 to 18 years treated with corpus callosotomy in our hospital from February 2003 to January 2007 was performed to analyze the incidence, examination and surgical treatment of the patients, and statistics Postoperative 1 year (1FU) and 5 years (5FU) control of epilepsy, changes in IQ and quality of life and influencing factors. Results The average age of onset was 5.57 years old, with an average duration of 9.71 years. Imaging abnormalities were found in 7 cases (25.0%). IQ test results showed moderate to severe mental retardation (FIQ ≤ 50) in 12 cases (42.86%). There were 17.86% (5 cases) and 10.71% (3 cases) of 1FU and 5FU respectively. At the same time, the seizure reduction ≥50% were 64.28% (18 cases) and 57.14% (16 cases) respectively. There was no significant difference between the two groups in 1FU and 5FU (P> 0.05). At 1FU, total IQ improved 46.43% (13/28) and total quality of life improved 64.28% (18/28). Changes in IQ and quality of life have nothing to do with the control of epilepsy. 4 cases of early postoperative complications, no long-term complications. Conclusion The anterior CCT can significantly reduce the seizures in young patients with LGS, improve QOL and IQ levels, and has good safety. Therefore, the anterior CCT can be used to carefully select the LGS surgical treatment.