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伽玛刀对药物难治性癫疒间病人认知功能的影响
引用本文:梁传栋,;刘娜,;曹红旭,;武江,;康进生,;郭韬,;岳向勇,;陈晓刚,;李文玲,;赵文清.伽玛刀对药物难治性癫疒间病人认知功能的影响[J].中国微侵袭神经外科杂志,2014(7):300-302.
作者姓名:梁传栋  ;刘娜  ;曹红旭  ;武江  ;康进生  ;郭韬  ;岳向勇  ;陈晓刚  ;李文玲  ;赵文清
作者单位:[1]河北省人民医院神经外二科,石家庄050051; [2]河北省人民医院消化内科,石家庄050051; [3]邢台医学高等专科学校第二附属医院防保科,054000; [4]唐山市丰润区第二人民医院神经外科,063000
摘    要:目的探讨伽玛刀治疗对药物难治性癫疒间认知功能的影响。方法回顾性分析41例行伽玛刀治疗的药物难治性癫疒间病人的临床资料,根据Engel分级评价癫疒间发作控制情况,瑞文标准推理能力测验(SPM)评价病人的认知功能,并分析影响认知功能的可能因素。结果治疗后达EngelⅠ级3例,EngelⅡ级9例,EngelⅢ级17例,EngelⅣ级12例。治疗后SPM评分较术前提高13例,下降4例,无明显变化24例。治疗前智商值为73.3±18.9,治疗后为77.3±19.8,两者差异显著(P<0.05);治疗后颞叶癫疒间与非颞叶癫疒间的认知功能差异无统计学意义(P>0.05);而EngelⅠ~Ⅲ级与EngelⅣ级病人认知功能差异有统计学意义(P<0.05)。结论伽玛刀可部分改善癫疒间病人认知功能,是治疗药物难治性癫疒间的安全、有效方法,具有良好应用前景。

关 键 词:癫疒间  神经行为学表现  放射外科手术

Effects of gamma knife on the cognitive function of patients with medically intractable epilepsy
Affiliation:Liang Chuandong, Liu Na, Cao Hongxu, Wu Jiang, Kang Jinsheng, Guo Tao, Yue Xiangyong, Chen Xiaogang, Li Wenling, Zhao Wenqing (1. Department of Neurosurgery 2. Department of Gastroenterology, Hebei Provincial People's Hospital, Shijiazhuang, Hebei 050051, China; 3. Department of Prevention and Health Care, Second Affiliated Hospital, Xingtai Medical College, Xingtai, Hebei 054000, China; 4. Department of Neurosurgery, Second People's Hospital of Fengrun District, Tangshan, Hebei 063000, China)
Abstract:Objective To explore the effects of gamma knife on the cognitive function of the patients with medically intractable epilepsy. Methods Clinical data of 41 patients with medically intractable epilepsy undergoing gamma knife treatment were analyzed retrospectively. Engel grade was used to assess the control situation of epileptic seizure. Raven's standard progressive matrices (SPM) score was applied to evaluate the cognitive function, and relative factors that might influence cognitive function were analyzed. Results Engel gradeⅠwas achieved in 3 patients after treatment, gradeⅡin 9, gradeⅢin 17 and gradeⅣin 12. Compared with the preoperation, the postoperative SPM score increased in 13 patients, decreased in 4 and unchanged in 24. The mean IQ score was 73.30± 18.9 at preoperation and 77.3±19.8 at postoperation, and significant difference was found between them (P〈0.05). There were no significant differences in cognition between patients with temporal epilepsy and non-temporal epilepsy after treatment (P〉0.05), while there were significant differences in cognition between patients of Engel gradeⅠtoⅢ and gradeⅣ (P〈0.05). Conclusion Gamma knife can partially improve the cognitive function of the patients with medically intractable epilepsy, is a safe and effective treatment with a good application prospect.
Keywords:epilepsy  neurobehavioral manifestation  radiosurgery
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