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选择性杏仁核海马切除术与颞叶前部切除术治疗颞叶癫痫的疗效比较:一项荟萃分析

Comparison of therapeutic effects between selective amygdalohippocampectomy and anterior temporal lobectomy for the treatment of temporal lobe epilepsy: a meta-analysis.

作者信息

Kuang Yongqin, Yang Tao, Gu Jianwen, Kong Bin, Cheng Lin

机构信息

Department of Neurosurgery, Chengdu Military General Hospital , Chengdu , P. R. China.

出版信息

Br J Neurosurg. 2014 Jun;28(3):374-7. doi: 10.3109/02688697.2013.841854. Epub 2013 Oct 7.

Abstract

BACKGROUND

Temporal lobe epilepsy (TLE) is a recurrent chronic nervous system disease. The conventional treatment is medicine. So far, anterior temporal lobectomy (ATL) and selective amygdalohippocampectomy (SAH) are becoming the two main approaches.

METHODS

To compare the therapeutic effects between SAH and ATL in the treatment of temporal lobe epilepsy, we conducted a meta-analysis of published randomized controlled trials. The review applied the search strategy developed by the Cochrane Epilepsy Group and the Rev. Man 5.0 software to analyze. We also drew the forest plots with Risk Ratio (RR) as effect size. Six studies were eligible, with a total of 626 patients (337 patients with SAH and 289 patients with ATL).

RESULTS

There was no statistical significance of postoperative seizure control rate after 1 year, as well as the increase rate and decrease rate of verbal memory function between SAH and ATL. There is no statistical difference of therapeutic effects between SAH and ATL in the treatment of temporal lobe epilepsy.

CONCLUSION

It is advised that clinically, physicians should choose the appropriate approach according to operation indications to improve the results of postoperative recovery.

摘要

背景

颞叶癫痫(TLE)是一种反复发作的慢性神经系统疾病。传统治疗方法是药物治疗。到目前为止,前颞叶切除术(ATL)和选择性杏仁核海马切除术(SAH)正成为两种主要的治疗方法。

方法

为比较SAH和ATL治疗颞叶癫痫的疗效,我们对已发表的随机对照试验进行了荟萃分析。该综述采用Cochrane癫痫小组制定的检索策略,并使用Rev. Man 5.0软件进行分析。我们还绘制了以风险比(RR)为效应量的森林图。共有6项研究符合条件,共计626例患者(SAH组337例,ATL组289例)。

结果

SAH和ATL术后1年的癫痫控制率,以及言语记忆功能的增加率和降低率,均无统计学意义。SAH和ATL治疗颞叶癫痫的疗效无统计学差异。

结论

建议临床上医生应根据手术指征选择合适的治疗方法,以提高术后恢复效果。

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