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通过症状自评量表90修订版评估内侧颞叶癫痫患者在进行皮质杏仁核海马切除术之后的精神症状变化。

Psychiatric symptom changes after corticoamygdalohippocampectomy in patients with medial temporal lobe epilepsy through Symptom Checklist 90 Revised.

作者信息

Guangming Zhang, Wenjing Zhou, Guoqiang Chen, Yan Zhu, Fuquan Zhang, Huancong Zuo

机构信息

Department of Neurosurgery, Institute of Neurological Disorder, Yuquan Hospital, School of Medicine Tsinghua University, Beijing 100049, China.

出版信息

Surg Neurol. 2009 Dec;72(6):587-91; discussion 591. doi: 10.1016/j.surneu.2009.02.004. Epub 2009 Jul 15.

DOI:10.1016/j.surneu.2009.02.004
PMID:19608243
Abstract

BACKGROUND

Corticoamygdalohippocampectomy (anterior temporal lobe resection plus amygdalohippocampectomy) is common in epilepsy surgery. Pre- and postoperative psychiatric disorders occurred sometimes in patients with refractory medial TLE. We want to know if CAH has an affirmative effect on the psychiatric symptom of patients with medial TLE through a quantitative method.

METHODS

Sixty-two patients with medial TLE who had CAH accomplished SCL-90-R questionnaires thrice (presurgical and postsurgical 1 and 2 years). Average GSI scores in SCL-90-R were calculated and statistically analyzed.

RESULTS

There was no statistical difference in the presurgical average GSI scores between Engel I and Engel II to IV subgroup. Postoperative 1 and 2 years' average GSI scores of Engel II to IV subgroup were both statistically higher than those of Engel I subgroup. There were no statistical differences between other subgroups in different time. Postsurgical 1 and 2 years' average GSI scores of the whole group and Engel I subgroup were statistically lower than those of presurgery. Postoperative 2 years' average GSI scores of the whole group and Engel I subgroup were statistically lower than those of postsurgical 1 year. For Engel II to IV subgroup, there were no statistical differences among the average GSI scores in different time.

CONCLUSION

Corticoamygdalohippocampectomy could improve the psychiatric symptoms of patients with TLE as assessed by the SCL-90-R. This improvement was related to the therapeutic effect and was not related to sex, lateralization, and MRI abnormality.

摘要

背景

皮质杏仁核海马切除术(前颞叶切除术加杏仁核海马切除术)在癫痫手术中很常见。难治性内侧颞叶癫痫患者有时会出现术前和术后精神障碍。我们想通过定量方法了解皮质杏仁核海马切除术对内侧颞叶癫痫患者的精神症状是否有积极影响。

方法

62例行皮质杏仁核海马切除术的内侧颞叶癫痫患者三次完成症状自评量表(SCL-90-R)问卷调查(术前、术后1年和2年)。计算SCL-90-R中的平均总症状指数(GSI)得分并进行统计学分析。

结果

恩格尔I级与恩格尔II至IV级亚组术前平均GSI得分无统计学差异。恩格尔II至IV级亚组术后1年和2年的平均GSI得分均显著高于恩格尔I级亚组。不同时间其他亚组之间无统计学差异。全组和恩格尔I级亚组术后1年和2年的平均GSI得分均显著低于术前。全组和恩格尔I级亚组术后2年的平均GSI得分显著低于术后1年。对于恩格尔II至IV级亚组,不同时间的平均GSI得分之间无统计学差异。

结论

皮质杏仁核海马切除术可改善内侧颞叶癫痫患者经SCL-90-R评估的精神症状。这种改善与治疗效果有关,与性别、病变侧别和磁共振成像异常无关。

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