颅内肿瘤切除前后皮层脑电图的变化与术后癫痫的.doc

但炜，重庆医科大学附属第一医院神经外科，副教授，主要从事神经电生理研究。邮编：400016。电话本文为重庆帀卫生局资助项目（面上：05-2-167）. 颅内肿瘤切除前后皮层脑电图的变化 对术后癫痫的预测价值 但 炜， 唐文渊， 刘福英， 石全红 （重庆医科大学附属第一医院神经外科，重庆 400016） 目的：探讨皮层脑电图（electrocorticography ECoG）在颅内肿瘤切除前后的变化特点及其对术后癫痫的预测价值。方法：选择95例颅内肿瘤患者，于病灶切除前后进行ECoG监测，根据ECoG上多棘波密度、波幅变化分为术后痫性放电增多组（A组）、不变组（B组）及减少组（C组）。术后癫痫根据发生时间分为早期癫痫（术后1周内）与晚期癫痫（1周后）。随访时间4年，比较病灶切除前后ECoG的变化与术后癫痫的相关性。结果：（1）95例颅内肿瘤患者病灶切除后ECoG显示A组13例（13.68%）, B组37例（38.95%），C组45例（47.37%）。（2）95例中术后早期癫痫32例（33.68%）, 分别为A组8例（61.54%）、B组13例（35.14%）、C组11例（24.44%）,三组间x2=6.2，P＜0.05,差异有统计学意义；晚期癫痫17例（17.89%），A、B、C 组分别为1例（7.69%）、7例(18.92%)、9例(20.00%)，三组间x2=1.04，P＞0.05,差异无统计学意义。（3）32例早期癫痫中有7例(21.88%)出现晚期癫痫，63例术后无早期癫痫的病例中，有10例（ 15.87%）出现晚期癫痫，二者经x2检验，x2=0.93, P＞0.05,差异无统计学意义。结论：颅内肿瘤切除前后的ECoG变化有助于预测术后早期癫痫；术后早期癫痫与晚期癫痫无关。 关键词：颅内肿瘤；皮层脑电图；癫痫。 Predictive value of electrocorticography on postoperative epilepsy in patients with intracranial tumors DAN Wei, TANG Wen-Yuan, LIU Fu-Ying, SHI Quan-Hong Department of neurosurgery, the First Chongqing 【Abstract】 objective: To explore predictive value of electrocorticography(ECoG) on postoperative epilepsy in patients with intracranial tumors. Methods: 95 patients with intracranial tumors were studied in our hospital and ECoG signals were recorded pre- and post-operation. According to the variation of the amplitude and density of spike waves on ECoG, the patients were divided into three groups: group A having more spike waves, group B having the same spike waves and group C having less spike waves after tumors were removed. The patients had four years of follow up and the epilepsy were divided into postoperative early epilepsy and late epilepsy . Results: （1）ECoG showed that A group, B group and C group separately were 13 cases（13.68%）, 37 cases（38.95%）and 45 cases（47.37%）.(2) 32 patients with early epilepsy were 8 cases（61.54%）in the group A, 13 cases（35.14%）in the group B and 11 cases（24.44%）in the group C, and three groups compared x2=6.2，P＜0.05. 17 patients（17.89%）which suffered late