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术前心理调适和手术结果是颞叶前部切除术后心理社会状态的决定因素。

Preoperative psychological adjustment and surgical outcome are determinants of psychosocial status after anterior temporal lobectomy.

作者信息

Hermann B P, Wyler A R, Somes G

机构信息

EpiCare Center, Baptist Memorial Hospital, Memphis, Tennessee 38103.

出版信息

J Neurol Neurosurg Psychiatry. 1992 Jun;55(6):491-6. doi: 10.1136/jnnp.55.6.491.

Abstract

This investigation evaluated the role of preoperative psychological adjustment, degree of postoperative seizure reduction, and other relevant variables (age, education, IQ, age at onset of epilepsy, laterality of resection) in determining emotional/psychosocial outcome following anterior temporal lobectomy. Ninety seven patients with complex partial seizures of temporal lobe origin were administered the Minnesota Multiphasic Personality Inventory (MMPI), Washington Psychosocial Seizure Inventory (WPSI), and the General Health Questionnaire (GHQ) both before and six to eight months after anterior temporal lobectomy. The data were subjected to a nonparametric rank sum technique (O'Brien's procedure) which combined the test scores to form a single outcome index (TOTAL PSYCHOSOCIAL OUTCOME) that was analysed by multiple regression procedures. Results indicated that the most powerful predictors of patients' overall postoperative psychosocial outcome were: 1) The adequacy of their preoperative psychosocial adjustment, and 2) A totally seizure-free outcome. Additional analyses were carried out separately on the MMPI, WPSI, and GHQ to determine whether findings varied as a function of the specific outcome measure. These results were related to the larger literature concerned with the psychological outcome of anterior temporal lobectomy.

摘要

本研究评估了术前心理调适、术后癫痫发作减少程度以及其他相关变量(年龄、教育程度、智商、癫痫发作起始年龄、切除部位)在确定颞叶前部切除术后情绪/心理社会结局方面的作用。对97例颞叶起源的复杂部分性癫痫患者在颞叶前部切除术前以及术后6至8个月分别进行明尼苏达多相人格调查表(MMPI)、华盛顿癫痫心理社会调查表(WPSI)和一般健康问卷(GHQ)测试。数据采用非参数秩和技术(奥布赖恩程序)进行处理,该技术将测试分数合并形成一个单一的结局指标(总体心理社会结局),并通过多元回归程序进行分析。结果表明,患者术后总体心理社会结局的最有力预测因素为:1)术前心理社会调适的充分程度,以及2)完全无癫痫发作的结局。分别对MMPI、WPSI和GHQ进行了额外分析,以确定研究结果是否因具体结局测量指标的不同而有所差异。这些结果与关于颞叶前部切除术心理结局的大量文献相关。

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