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目的探讨脑电图中出现双侧同步节律性慢波(bilateral synchronous rhythmic slow wave)在幕上肿瘤患者继发癫痫中的易感性。方法回顾性分析我院自2008年1月至2010年7月255例幕上肿瘤患者的动态脑电图(active elec-troencephalogram,AEEG)结果,根据术前是否伴有癫痫发作,将病例分为A组(有癫痫发作),B组(无癫痫发作)。将脑电图中仅有双侧同步节律性慢波定义为变量a,以痫样放电为参照,对仅出现痫样放电定义为变量b,同时具有双侧同步节律性慢波和痫样放电定义为变量a+b。分析三变量在2组间的差异,探讨变量a与幕上肿瘤继发癫痫的易感性。结果①术前变量a在幕上肿瘤患者中的出现率为56.86%。②术前变量a在A组中的出现率高于B组(66.23%vs 52.81%,P<0.05);A、B两组变量b和a+b出现率比较差异均有显著性(29.87%vs 9.55%,66.23%vs 7.30%,P<0.05)。进一步分析两变量之间癫痫发生率的差异显示:A组中出现变量a+b略高于变量b(P<0.05)。③术后45例出现早期癫痫,其中35例(77.78%)AEEG中描记到变量a或变量a+b,将术后双侧同步节律性慢波的出现率与术后癫痫发作率进行一致性分析得知两者有高度一致性(k=0.600 2)。结论双侧同步节律性慢波可能增加幕上肿瘤患者癫痫发作的易感性。
Objective To investigate the susceptibility of bilateral synchronous rhythmic slow wave (EOS) to secondary epilepsy in patients with supratentorial tumors. Methods A retrospective analysis of 255 patients with supratentorial tumor in our hospital from January 2008 to July 2010 was performed on the basis of the results of active electroencephalogram (AEEG). According to the preoperative epileptic seizure, the patients were divided into Group A (with seizures), Group B (without seizures). Only the bilateral synchronous rhythmic EEG slow wave is defined as variable a, with epileptiform discharge as a reference, only the occurrence of epileptiform discharge is defined as the variable b, simultaneously with bilateral rhythmic slow wave and epileptiform discharge Defined as variable a + b. Analysis of three variables in the difference between the two groups to explore the variable a and supratentorial tumor secondary epilepsy susceptibility. Results ① Preoperative variable a was 56.86% in supratentorial tumor patients. (2) The incidence of preoperative variable a in group A was higher than that in group B (66.23% vs 52.81%, P <0.05). There was significant difference in the occurrence rates of b and a + b in group A and B (29.87% vs 9.55%, 66.23% vs 7.30%, P <0.05). Further analysis of the difference in the incidence of epilepsy between the two variables showed that the variables a + b in group A were slightly higher than those in variable b (P <0.05). (3) There were 45 cases of early epilepsy after operation, of which 35 cases (77.78%) were labeled with variable a or variable a + b in AEEG. The coincidence of the occurrence rate of bilateral synchronous rhythmic slow wave and postoperative seizure rate Analysis found that there is a high degree of agreement (k = 0.600 2). Conclusions Bilateral synchronized rhythmic slow wave may increase the susceptibility to epileptic seizures in patients with supratentorial tumors.