Spencer Susan S, Berg Anne T, Vickrey Barbara G, Sperling Michael R, Bazil Carl W, Haut Sheryl, Langfitt John T, Walczak Thaddeus S, Devinsky Orrin
Department of Neurology, Yale University School of Medicine, New Haven, CT 06520-8018, USA.
Ann Neurol. 2007 Oct;62(4):327-34. doi: 10.1002/ana.21131.
Health-related quality of life (HRQOL) improves after resective epilepsy surgery, but data are limited to short follow-up in mostly retrospective reports, with minimal consideration of other potential factors that might influence HRQOL.
In a prospective multicenter study, 396 patients underwent resective epilepsy surgery. They completed the Quality of Life in Epilepsy Inventory-89 (QOLIE-89) before surgery, within 6 months, and at approximately yearly intervals after surgery. Seizure outcome was ascertained by phone calls every 3 months, and dates of postoperative seizures were chronicled. Overall HRQOL as measured by the QOLIE-89 was evaluated with respect to seizure outcome using logistic regression.
QOLIE-89 scores increased significantly at the first postoperative measurement (within 6 months after surgery) in the cohort overall; subsequent changes over time were sensitive to seizure-free and aura-free status. After adjusting for baseline scores, the corresponding postsurgical QOLIE-89 overall, and four dimension scores, increased as a function of square root of time seizure-free, and independently as a function of square root of time aura free, leveling by 2 years of stable seizure (aura) status. HRQOL was not independently related to duration of epilepsy, duration of intractable epilepsy, or continuation of medications.
HRQOL improves early after surgery, regardless of seizure outcome. Subsequent changes parallel length of time seizure free or aura free, stabilize after 2 years, and are unrelated to duration of epilepsy, duration of intractable epilepsy, or continued medication use.
在切除性癫痫手术后，与健康相关的生活质量（HRQOL）有所改善，但数据仅限于大多为回顾性报告中的短期随访，对其他可能影响HRQOL的潜在因素考虑极少。
在一项前瞻性多中心研究中，396例患者接受了切除性癫痫手术。他们在手术前、术后6个月内以及术后大约每年完成癫痫生活质量量表-89（QOLIE-89）。每3个月通过电话确定癫痫发作结果，并记录术后癫痫发作日期。使用逻辑回归分析，根据癫痫发作结果评估由QOLIE-89测量的总体HRQOL。
在整个队列中，术后首次测量（术后6个月内）时QOLIE-89评分显著增加；随后随时间的变化对无癫痫发作和无先兆状态敏感。在调整基线评分后，相应的术后QOLIE-89总体评分以及四个维度评分，随着无癫痫发作时间的平方根增加，并且独立于无先兆时间的平方根增加，在2年的稳定癫痫发作（先兆）状态下趋于平稳。HRQOL与癫痫持续时间、难治性癫痫持续时间或药物持续使用无独立相关性。
无论癫痫发作结果如何，HRQOL在手术后早期都会改善。随后的变化与无癫痫发作或无先兆的时间长度平行，在2年后稳定，并且与癫痫持续时间、难治性癫痫持续时间或持续用药无关。
