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目的评价深部电极引导立体定向手术治疗颞叶癫癎的疗效。方法对94例无明显病灶的颞叶癫癎病人采用深部电极引导立体定向海马杏仁复合体热凝毁损术,术后随访癫癎控制效果。对其中27例行手术前后神经心理学检查,评价手术对脑功能的影响。结果80例获1～7年随访,其中发作完全消失47例(58.8%),减少75%以上18例(22.5%),减少50%～75%9例(11.2%),无变化6例(7.5%)。神经心理学检查表明手术前后智力、记忆力差异无统计学意义(均P>0.05)。结论选择合理手术入路及术中应用深部电极取代以往的解剖学定位,达到理想有效的毁损范围,有助于提高颞叶癫癎的手术疗效。
Objective To evaluate the curative effect of deep electrode-guided stereotactic surgery on temporal lobe epilepsy. Methods 94 cases of temporal lobe epilepsy patients without obvious lesions were treated with deep electrode-guided stereotaxic hippocampal alveolar complex thermocoagulation and postoperative follow-up of epilepsy control. Neuropsychological tests were performed on 27 of them before and after surgery to evaluate the effect of surgery on brain function. Results Eighty patients were followed up for 1 to 7 years, of which 47 cases (58.8%) disappeared completely, 18 cases (22.5%) decreased more than 75%, 9 cases (11.2%) decreased by 50% ~ 75% 7.5%). Neuropsychological tests showed that there was no significant difference in intelligence and memory before and after surgery (all P> 0.05). Conclusion The selection of reasonable surgical approach and intraoperative use of deep electrodes to replace the previous anatomical location, to achieve the desired effective range of damage, help to improve the surgical efficacy of temporal lobe epilepsy.