《中国康复理论与实践》

《中国康复理论与实践》

• 临床研究 • 上一篇    下一篇

难治性癫痫患儿大脑半球离断术后神经功能的影响因素①

杨海波1a，刘思维2，刘晓燕1b，王文1b，刘庆祝1b，王爽1b，姜玉武1b，王若凡1b，蔡立新1b   

  1. 1. 北京大学第一医院，a. 小儿外科，b. 儿童癫痫中心，北京市100034；2. 首都医科大学附属北京朝阳医院神经内科，北京市100020。
  • 出版日期:2016-08-25 发布日期:2016-09-22

Factors Related with Neurological Function in Children after Hemispherectomy for Intractable Epilepsy

YANG Hai- bo1a, LIU Si- wei2, LIU Xiao- yan1b, WANG Wen1b, LIU Qing- zhu1b, WANG Shuang1b, JIANG Yu- wu1b, WANG Ruo-fan1b, CAI Li-xin1b   

  1. 1. a. Pediatric Surgery Department; b. Pediatric Epilepsy Center, Peking University First Hospital, Beijing 100034, China; 2. Department of Neurology, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
  • Published:2016-08-25 Online:2016-09-22

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摘要： 目的探讨大脑半球离断术患儿术前各项临床指标对术后各项神经功能的影响。方法回顾性分析本中心自2014 年5月~2015 年6 月实施大脑半球离断术的患儿33 例。收集手术前临床资料。通过门诊及电话随访，以结构化问卷评估术前、术后神经功能状态。采用Fisher 精确概率法对术前临床资料与术后功能进行单因素分析。结果MRI为双侧病变对患儿术后肢体活动能力的预后有重要影响(P<0.001)。患儿年龄影响术后肢体活动能力的预后(以3 岁为界定)(P<0.001)，年龄小的患儿术后功能恢复较好，年龄对口语能力(以3 岁为界)及阅读能力(以10 岁为界)也有一定影响(P<0.001)。结论难治性癫痫大脑半球离断术术后神经功能预后与患儿对侧半球病变及患儿年龄有关。

关键词: 难治性癫痫, 大脑半球离断术, 神经功能, 预后

Abstract: Objective To explore the factors related with neurological function in children after hemispherectomy for intractable epilepsy. Methods Thirty-three children suffered hemispherectomy from May, 2014 to June, 2015 were analyzed. Their preoperative data were collected. A structured questionnaire was used to evaluate the neurological function. The relationship between preoperative parameters and postoperative functional outcomes was analyzed. Results Bilateral lesions in MRI (P<0.001) and age (P<0.001) were related with functional outcome.Conclusion The prognosis of hemispherectomy for children with intractable epilepsy is related to the contralateral lesion and age.

Key words: intractable epilepsy, hemispherectomy, neurological function, prognosis