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本文概述了迷走神经刺激术治疗癫痫的历史、现状、治疗机制、适应证、禁忌证、术前评估、手术方法以及疗效评定。迷走神经刺激术无需对癫痫灶进行精确定位,通过刺激迷走神经可使顽固性癫痫的发作次数减少,对部分病人甚至可以完全控制,为不能进行切除手术或切除术后复发的顽固性癫痫患者提供了新的治疗途径。目前全世界已有超过50,000例病人使用迷走神经刺激术,但在我国仅有零星开展。国外大宗病例统计表明VNS术后24个月5%~9%的病人发作完全停止,癫痫发作次数平均减少50%左右,但也有10%的病人无效。相信随着研究的深入,迷走神经刺激术的临床应用将会更加广泛。
This article outlines the history, current status, treatment mechanism, indications, contraindications, preoperative evaluation, surgical methods and evaluation of curative effect of vagus nerve stimulation for epilepsy. Vagus nerve stimulation without the need for precise positioning of epileptic foci, through the stimulation of the vagus nerve epilepsy can stubborn episodes reduce the number of patients in some patients can even be completely controlled, can not be resection or recurrence of intractable epilepsy patients with a new Therapeutic approach. Currently, more than 50,000 patients worldwide have vagal stimulation, but only sporadically in our country. According to the statistics of a large number of foreign patients, 5% to 9% of the 24 patients after VNS completely stopped their seizures. The number of seizures decreased by about 50% on average, but 10% of the patients were ineffective. Believe that with the deepening of research, the clinical application of vagus nerve stimulation will be more extensive.