摘要
目的:颞叶内侧结构(杏仁核海马等)与颞叶癫痫的发生和传播密切相关。本文采用改良Spencer法选择性切除杏仁核海马,探讨在治疗内侧型颞叶癫痫的同时,尽可能保留颞叶新皮质的功能。方法:结合应用EEG、MRS、PETCT等检查结果对适合手术洽疗的200例内侧型颞叶癫痫病例的癫痫灶进行定位诊断,利用耳前直切口、三角形小骨片开颅,采用改良Spencer法,切除前颞叶颞下回2cm脑组织后进入侧脑室下角,显微镜下清晰显露杏仁核海马后酌情切除杏仁核、海马头部和体部。病理标本送常规检查。术后密切随访,观察近期疗效及长期随访结果。结果:200例中手术疗效满意173例。其中EngelⅠ级155例,Ⅱ级18例,Ⅲ级20例,Ⅳ级7例。病理标本提示170例(85%)存在明显海马硬化。术后无并发症发生。方法:改良Spencer法选择性切除杏仁核海马,对内侧型飘叶癫痫疗效满意,且较常规手术入路安全易行。
Objective： To discuss the Surgical treatment of mesial temporal lobe epilepsy by selective amygdalo - hippocampectomy via the modified Spencer＇ s approach. Method： Two hundred patients with intractable mesial temporal lobe epilepsy were identified with EEG. MRS. PETCT et. al., treated by selective amygdalo - hippocampectomy via the modified Spencer＇ s approach. The results of operation and follow - up were analysed.Results： As to seizure outcome, all patients were benefied from surgery. Surgical results were satisfactory in 173 patients （Engel Ⅰ in 155, Engel Ⅱ in 18 ） . There was no surgical complication. Condnsion： Operation is an effective way for the treatment of mesial temporal lobe epilepsy. Selective amygdalo- hippocampectomy via the modified Spencer＇ s approach is a safe and effective choice for mesial temporal lobe epilepsy.
出处
《福州总医院学报》
2007年第1期11-12,共2页
Journal of Fuzhou General Hospital
