不同病程颞叶癫痫术后疗效及相关性分析

Surgical outcomes of temporal lobe epilepsy patients with different disease courses：a comparative and correlative analysis

摘要:

目的 探讨不同病程颞叶癫痫患者术后疗效有无差异及手术疗效与病程有无相关关系。方法 回顾性分析2002年1月-2011年1月在泸州医学院附属成都三六三医院神经外科接受手术治疗的颞叶癫痫患者183例，根据Engel分级评估分析不同病程患者术后疗效有无差异以及手术疗效与病程有无相关关系。结果 早期手术治疗组术后无癫痫发作率占78.9%；中期手术治疗组术后无癫痫发作率占67.9%；晚期手术治疗组术后无癫痫发作率占58.6%。早期手术治疗组术后无癫痫发作率高于中期手术治疗组和晚期手术组，疗效差异有统计学意义（P<0.05）；颞叶癫痫病程与术后疗效存在负相关关系（r=-0.213，P=0.002），即病程越长，疗效越差。结论 早期手术干预可能更加有利于控制癫痫发作，提高患者生存质量。

Abstract:

Objective To compare the surgical outcomes of temporal lobe epilepsy patients with different disease courses and to investigate the relationship between surgical outcome and disease course.Methods To compare the surgical outcomes of temporal lobe epilepsy patients with different disease courses and to investigate the relationship between surgical outcome and disease course.Results A retrospective analysis was performed on 183 patients with temporal lobe epilepsy who received surgical treatment in the Department of Neurosurgery, Affiliated 363 Hospital, Luzhou Medical College from January 2002 to January 2011. The surgical outcomes of patients with different disease courses were evaluated based on Engel's classification, and the relationship between disease course and surgical outcome was analyzed. Results After operation, the early surgical treatment group had a significantly higher seizure-free rate than the middle surgical treatment group and late surgical treatment group (78.9% vs 67.9% and 58.6%, P<0.05). The course of disease was negatively correlated with surgical outcome (r=-0.213, P=0.002); the longer the duration of disease, the worse the surgical outcome.Conclusions Early surgical intervention may be more beneficial for controlling temporal lobe epilepsy and improving patient's quality of life.