Department of Clinical Neurosciences, University of Calgary, Calgary, AB, Canada.
Epilepsy Behav. 2011 Aug;21(4):441-5. doi: 10.1016/j.yebeh.2011.05.005. Epub 2011 Jun 21.
We systematically reviewed evidence-based determinants of health-related quality of life (QOL) in adults undergoing epilepsy surgery and assessed the effect of study methods. Medline, Embase, and the Cochrane library (1950-2008) were searched systematically. Two authors independently performed every step of the review. We obtained the proportion of studies reporting statistically significant positive or negative impact on QOL. Of 39 eligible studies, 32 assessed the impact of surgery on QOL and 29 (90.6%) found a significant positive effect. The most prevalent preoperative determinant was psychological function. Seizure freedom was the most prevalent postoperative determinant (80% of studies), followed by antiepileptic drug adverse events, employment status, and psychological function. Psychosocial (95%), physical (91%), and overall QOL (90%) domains improved most frequently, whereas role limitation (63%) and cognition (78%) improved least frequently. Methods, choice of instrument, and time of measurement influenced QOL outcomes and should be carefully chosen in future studies.
我们系统地回顾了与接受癫痫手术的成年人相关的健康相关生活质量（QOL）的循证决定因素，并评估了研究方法的效果。系统地检索了 Medline、Embase 和 Cochrane 图书馆（1950-2008 年）。两位作者独立完成了审查的每一步。我们获得了报告对 QOL 有统计学意义的积极或消极影响的研究比例。在 39 项合格的研究中，32 项评估了手术对 QOL 的影响，其中 29 项（90.6%）发现了显著的积极影响。最常见的术前决定因素是心理功能。无癫痫发作是最常见的术后决定因素（80%的研究），其次是抗癫痫药物不良反应、就业状况和心理功能。心理社会（95%）、身体（91%）和总体 QOL（90%）领域最常改善，而角色限制（63%）和认知（78%）改善最少。方法、工具的选择和测量时间影响 QOL 结果，在未来的研究中应谨慎选择。
