Moritake Kouzo, Mikuni Nobuhiro, Akiyama Yasuhiko, Nagai Hidemasa, Maruyama Nobuyuki, Takada Daikei, Daisu Mitsuhiro, Nagasako Noriko, Hashimoto Nobuo
Department of Neurosurgery, Shimane University School of Medicine, Izumo, Shimane, Japan.
Neurol Med Chir (Tokyo). 2009 Jul;49(7):281-6. doi: 10.2176/nmc.49.281.
The long-term postoperative improvement of quality of life (QOL) and employment were investigated in patients undergoing resection of epileptogenic lesions detected by magnetic resonance (MR) imaging to identify the associated preoperative factors. Thirty of 47 patients who underwent lesionectomy between 1987-2001 replied to questionnaires. Patients with extratemporal resection outnumbered those with temporal lobe resection. The mean follow-up period was 12.4 +/- 3.7 years. An arbitrary score for quantitatively assessing QOL was assigned. The mean increases in QOL score points were significantly higher in the late childhood onset group than those in the early childhood onset group, and were also significantly higher in the temporal resection group and extratemporal resection of non-dysplastic cortical pathology group than in the extratemporal resection of dysplastic cortical pathology group. Postoperative QOL improvement and occupational status of patients depended on the completeness of seizure control. Resection of lesions detected by MR imaging in patients with intractable epilepsy resulted in effective long-term QOL improvement and postoperative occupational status. Favorable outcome was related mainly to the pathology of the epileptogenic lesions, whether the lesion site was temporal or extratemporal, and the completeness of seizure control.
对接受磁共振（MR）成像检测出的致痫性病变切除术的患者，研究其术后生活质量（QOL）的长期改善情况及就业情况，以确定相关术前因素。1987年至2001年间接受病变切除术的47例患者中有30例回复了问卷。颞叶外切除术患者多于颞叶切除术患者。平均随访期为12.4±3.7年。设定了一个用于定量评估生活质量的任意评分。儿童晚期起病组的生活质量评分点平均增幅显著高于儿童早期起病组，颞叶切除术组和非发育异常皮质病变的颞叶外切除术组的生活质量评分点平均增幅也显著高于发育异常皮质病变的颞叶外切除术组。患者术后生活质量的改善和职业状况取决于癫痫发作控制的完整性。对难治性癫痫患者进行MR成像检测出的病变切除术可有效改善长期生活质量并提高术后职业状况。良好的结果主要与致痫性病变的病理、病变部位是颞叶还是颞叶外以及癫痫发作控制的完整性有关。
