难治性颞叶癫痫患者行前颞叶切除术后认知功能和生活质量的临床疗效探究-现代医学

难治性颞叶癫痫患者行前颞叶切除术后认知功能和生活质量的临床疗效探究

单位：北京航天中心医院神经外科, 北京 100039

分类号：R742.1

出版年·卷·期（页码）：2018·46·第二期（153-156）

摘要：

目的：探究难治性颞叶癫痫患者行前颞叶切除术后认知功能和生活质量的临床疗效。方法：选择2013年6月至2015年6月期间在我院接受治疗的难治性颞叶癫痫患者126例，其中，接受前颞叶切除术的92例，采取非手术治疗的34例。对术前和术后1个月、1年和2年两组患者的癫痫发病率、认知功能及生活质量情况进行比较分析。结果：术前，两组癫痫患者的发病频率无显著差异（P>0.05），术后1个月，手术组患者的总体发病频率显著低于非手术组（P<0.05），尤其术后1年和2年，手术组患者的癫痫次数控制程度极显著优于非手术组（P<0.001）。术前，患者的VIQ、PIQ、FIQ和MQ 4个维度无显著差异（P>0.05），术后1个月，手术组患者记忆功能下降，且显著低于非手术组（P<0.05），其他指标和非手术组比较无显著差异（P>0.05），而术后1年之后，手术组患者的认知功能显著改善，且优于非手术组，差异有统计学意义（P<0.05），和术前比较，非手术组患者的认知功能无显著改善。随访2年，手术组患者的生活质量显著高于非手术组，差异显著有统计学意义（P<0.05）。结论：远期疗效观察显示，前颞叶切除术难可以一定程度上改善难治性颞叶癫痫患者的认知功能，显著控制了癫痫发病率，提高了生活质量水平。

Objective: To investigate the clinical effect of cognitive function and quality of life in patients with intractable temporal lobe epilepsy after anterior temporal lobectomy. Methods: 126 patients with refractory temporal lobe epilepsy treated in our hospital from June 2013 to June 2015 were selected. Among them, 92 patients underwent anterior temporal lobectomy and 34 patients underwent non-surgical treatment. 1 months before the operation and 1 months, 1 year and 2 years after the operation, the epilepsy incidence, the cognitive function and the quality of life of the patients were compared and analyzed. Results: Before the operation, there was no significant difference of epilepsy incidence between the two groups(P>0.05). 1 months after surgery, the overall epilepsy incidence of patients in operation group was significantly lower than the non-operation group(P<0.05), and the degree of epilepsy control in operation group were significantly better than that in the non-operation group(P<0.001) especially after 1 years and 2 years of the operation. Before the operation, there was no significant difference of VIQ, PIQ, with FIQ and MQ between the two group(P>0.05). 1 months after surgery, the memory function of patients in operation group was significantly lower than that in the non-operation group(P<0.05), and no significant difference of other indexes was found between the two group(P>0.05).But one year after operation, the cognitive function of patients in operation group was significantly improved and better than that in non-operation group, the difference was statistically significant(P<0.05).The cognitive function of patients in the non-operation group had no significant improvement compared with pre operation. During 2 years of follow-up, the quality of life of patients in the operation group was significantly higher than that in the non-operation group, and the difference was statistically significant(P<0.05). Conclusion: The long-term results show that anterior temporal lobectomy can improve the cognitive function of patients with intractable temporal lobe epilepsy to a certain extent, which also can significantly control the incidence of epilepsy and improve the quality of life of patients.

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