幕上胶质瘤继发癫痫患者皮层脑电异常放电脑组织-第三军医大学学报.DOCVIP

幕上胶质瘤继发癫痫患者皮层脑电异常放电脑组织的病理学研究 方 升[、2]，熊伟茗[1]，但 炜[1]，王超[1]，詹 彦[1]，谢延风[1]，石全红[1] （[1]重庆医科大学附属第一医院神经外科,重庆,400016 [2]成都市第三人民医院，成都, 610031） [摘要] 目的 探讨幕上胶质瘤继发癫痫患者皮层脑电异常放电脑组织的病理学改变。方法 选择28例首次以癫痫发作入院的非功能区胶质瘤患者，在术中皮层脑电（electrocorticography ECoG）监护下行肿瘤切除+痫样放电切除术。将切除有癫痫样放电的脑皮质作为实验组，无痫样放电的显微镜下显示肿瘤周边正常的哑区组织（胶质瘤切除附带的）或内减压脑组织作为对照组。分析比较实验组与对照组术后病理检查的结果及实验组ECoG波型特点。结果 （1）病理特点：28例实验组中15例(53.57%)发现胶质瘤细胞，7例(25.00%)单纯胶质细胞增生,6例(21.43%)患者示脑组织充血水肿。13例对照组中3例(23.08%)出现胶质细胞增生，6例(46.15%)单纯充血水肿，4例(30.77%)为正常脑组织。术后病检结果实验组胶质瘤或胶质增生明显高于对照组（P0.005）。（2）ECoG波型特点：实验组28例中22例术后病检显示胶质瘤或胶质增生者，ECoG显示17例（77.27%）为反复出现的单个极高幅棘波、多棘慢波，5例（22.72%）））Pathological nature of brain tissue with ECoG abnormalities on the secondary epilepsy in patients with supratentorial glioma Fang Sheng1、2, Xiong Weiming1, Dan Wei1, Wang Chao1, Zhan Yan1, Xie Yanfeng1, Shi Quanhong1 (1.Department of Neurosurgery,the First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016; 2. Department of Neurosurgery, The Third People＇s Hospital of Chengdu, Chengdu 610031) [Abstract] Objective: To explore the pathological nature of brain tissue with electrocorticography(ECoG) abnormalities on the secondary epilepsy in patients with supratentorial glioma. Methods: To select 28 cases admitted by seizures for the first time in patients with nonfunctional areas glioma. By the ECoG monitoring, to undergo tumor and epileptiform discharges resection. It is defined the resected brain cortex with epileptic discharges as the experimental group, and normal dumb organization(parenthesis of glioma resection) without epileptic discharges under the microscope in the tumor surrounding or decompression brain tissue as the control group. To analysis and compare the postoperative pathologic results both in experimental group and control group, and to analysis the specific ECoG wave type of the experimental group. Results: (1) Pathological features: A total of 28 cases in the experimental group, 15 cases(53.57%) found the glioma cells, 7 cases(25.00%