摘要
目的探讨胼胝体切开治疗难治性癫痫的改良手术方法。方法回顾性分析上海交通大学医学院附属仁济医院神经外科自2003年7月至2010年7月治疗的36例难治性癫痫患者临床资料.对改良的小骨窗胼胝体切开术皮肤切口、骨瓣设计、术式优缺点及术中注意事项等情况进行总结。结果36例患者术中均采用改良的“S”形或近似马蹄形切15、梯形小骨窗(上底边、下底边、高分别为2cm、4cm、2.5cm),在显微镜下经纵裂人路切开胼胝体前部2/3。术后随访9~12个月,Engel评分:1级6例,2级14例,3级12例,4级4例。结论改良小骨窗胼胝体切开术具有创伤小、愈合快、术后并发症少等优点,值得临床进一步推广。
Objective To summarize the effectiveness of improved surgical techniques of corpus callosotomy in patients with refractory epilepsy. Methods A retrospective analysis was performed on the clinical data of 36 patients with refractory epilepsy, admitted to our hospital from July 2003 to July 2010; the incision via improved small bone window was summarized on skin incision, bone flap design, surgical advantages and disadvantages, and intraoperative precautions. Results A S-shaped or an approximately U-shaped incision was made in the right frontal scalp. The craniotomy was performed with a small trapezoid bone window (the topline, the baseline and the height: 2, 4 and 2.5 cm, respectively). With the help of microscope, the extent of sectioning consisted of the anterior 2/3 of the total length of the corpus callosum. Post-surgical outcome was assessed according to Engel' s scale scores for 9 to 12 months of follow-up: 6 patients were in grade I, 14 in grade II, 12 in grade III and 4 in grade IV. Conclusion Improved corpus callosotomy has such advantages as little damage to the tissues, few complications and quick recovery, indicating that it is worth for further generalization.
出处
《中华神经医学杂志》
CAS
CSCD
北大核心
2012年第9期920-922,共3页
Chinese Journal of Neuromedicine
关键词
胼胝体切开术
难治性癫痫
小骨窗
Corpus callosotomy
Refractory epilepsy
Small bone window