[1]郑　玺　顿晓熠.迷走神经刺激术对药物难治性癫痫患者认知功能的影响及其相关因素分析[J].中国临床神经外科杂志,2017,(03):142-144.[doi:10.13798/j.issn.1009-153X.2017.03.005]
　ZHENG Xi,DUN Xiao-yi..Observation of cognitive function and analysis of factors related to it in patients with intractable epilepsy after treatment by vagus nerve stimulation[J].,2017,(03):142-144.[doi:10.13798/j.issn.1009-153X.2017.03.005]
点击复制

迷走神经刺激术对药物难治性癫痫患者认知功能的影响及其相关因素分析()
分享到：

《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
期数:
2017年03期
页码:
142-144
栏目:
论著
出版日期:
2017-03-20

文章信息/Info

Title:
Observation of cognitive function and analysis of factors related to it in patients with intractable epilepsy after treatment by vagus nerve stimulation
文章编号:
1009-153X（2017）03-0142-03
作者:
郑　玺　顿晓熠
830000 乌鲁木齐，解放军第474医院神经外科
Author(s):
ZHENG Xi;  DUN Xiao-yi.
Department of Neurosurgery, The 474th Hospital, PLA, Urumqi 830000, China
关键词:
药物难治性癫痫; 迷走神经刺激术; 认知功能; 相关因素
Keywords:
Intractable epilepsy;  Vagus nerve stimulation;  Cognitive function;  Related factors
分类号:
R 742.1; R 651.1+1
DOI:
10.13798/j.issn.1009-153X.2017.03.005
文献标志码:
A
摘要:
目的 探讨迷走神经刺激术对药物难治性癫痫患者认知功能的影响及其相关因素。方法 2014年1月至2015年4月收治符合标准药物难治性癫痫40例，均经MRI、视频脑电图、PET或SPECT等检查与评估后行迷走神经刺激术治疗。采用蒙特利尔认知功能量表进行认知功能评定，根据中国修订版韦氏成人智力量表、中国修订版韦氏记忆测验量表等评估言语智商、操作智商。结果 术后3、6、12个月蒙特利尔认知功能量表评分分别为（22.3±4.6）分、（23.5±3.1）分、（25.2±2.9）分，均显著高于术前[（18.9±3.5）分；P<0.05]。单因素分析和多元线性回归分析显示年龄、抗癫痫药物服用种类显著影响患者言语智商（P<0.05），致病灶位置、全面强直阵挛发作、癫痫发作频率显著影响患者操作智商（P<0.05）。结论 迷走神经刺激术能有效改善药物难治性癫痫患者认知功能，但治疗前需对患者认知功能进行评估，减少或去除相关影响因素，选取对患者认知功能影响较小的药物、手术进行干预治疗，最大程度控制癫痫发作，减轻癫痫对患者认知功能造成的损害。
Abstract:
Objective To study the change in cognitive function in the patients with intractable epilepsy (IE) treated by vagus nerve stimulation (VNS), and analyze the factors related to the change in the cognitive function. Methods MRI, video electroencephalograph or single photon emission computed tomography were performed in 40 patients with IE admitted to the hospital from January, 2014 to April, 2015. All the patients were treated by VNS. The changes in the cognitive function after VNS were observed and its related factors were analyzed in all the patients. Results The cognitive function scores, which were (22.3±4.6) points, (23.5±3.1) points, (25.2±2.9) points respectively 3, 6, 12 months after the VNS, were significantly higher respectively than that [(18.9±3.5) points] before VNS in these patients (P<0.05). The cognitive function was significantly related to the patients’ age, types of anti-epileptic drug, site of epileptogenic focus, epileptics with generalized tonic clonic seizure and frequency of epileptic seizure in the patients with IE after VNS (P<0.05). Conclusion VNS can effectively improve patients’ cognitive function in the patients with IE. But patients’ cognition should be evaluated before treatment so as to reduce or eliminate the effects of the related factors. Selecting drug with less effect on the cognitive function, controlling the generalized tonic clonic seizure and frequency of epileptic seizure and so on are helpful to improvement of the cognitive function in the patients with IE after VNS.

参考文献/References:

[1] 刘翠翠，陈诗赟，朴月善，等. 难治性癫痫相关脑炎的临床 病理学观察[J]. 中华病理学杂志，2016，45（5）：318-323.
[2] 吕梦娜. 难治性癫痫持续状态研究进展[J]. 中华实用诊断 与治疗杂志，2015，29（3）：212-214.
[3] 申玉勤，邓艳春. 迷走神经刺激术治疗难治性癫痫的研究 进展[J]. 临床神经病学杂志，2014，27（4）：313-315.
[4] 刘爱华，宋　璐，王玉平. 迷走神经刺激术在难治性癫痫 领域的临床进展[J]. 中华神经医学杂志，2013，12（1）： 96-99.
[5] van Iterson L, Zijlstra BJH, Augustijn PB, et al. Duration of epilepsy and cognitive development in children: a longitu- dinal study [J]. Neuropsychology, 2014, 28(2): 212-221.
[6] 颜惠真，江建东，原雨灵，等. 难治性癫痫患者语言及记忆 功能测试的相关因素[J]. 中华行为医学与脑科学杂志， 2016，25（5）：432-436.
[7] 桂秋萍. 癫痫临床病理诊断与新分型解析[J]. 诊断病理学 杂志，2013，20（5）：257-262.
[8] 孙洪吉，谢　越，张晓红，等. 蒙特利尔认知评估量表的条 目分析[J]. 中华老年心脑血管病杂志，2014，16（4）：387- 390.
[9] 李南林，夏　峰，冯国栋，等. 迷走神经刺激治疗7例难治 性癫痫[J]. 中国神经精神疾病杂志，2014，40（4）：234- 236.
[10] Han ZT, Chen QX. Curative effect and costs of surgical and gamma knife treatments on intractable epilepsy caused by temporal-hippocampal sclerosis [J]. Genet Mol Res, 2015, 14(3): 8555-8562.
[11] Kim SE, Lee JH, Chung HK, et al. Alterations in white mat- ter microstructures and cognitive dysfunctions in benign childhood epilepsy with centrotemporal spikes [J]. Eur J Neurol, 2014, 21(5): 708-717.
[12] 黄琴蓉，肖　农. 癫痫患者术后认知功能障碍的研究进展 [J]. 中华物理医学与康复杂志，2013，35（5）：423-426.

相似文献/References:

[1]张王成 综述　黄书岚 审校.成人难治性部分发作性癫痫的药物治疗研究进展[J].中国临床神经外科杂志,2017,(03):197.[doi:10.13798/j.issn.1009-153X.2017.03.028]
[2]关宇光　于思科　刘长青　张　尧　陈思畅　丁浩然　周　健　栾国明.立体定向脑电图引导下射频热凝毁损术治疗药物难治性癫痫[J].中国临床神经外科杂志,2017,(06):369.[doi:10.13798/j.issn.1009-153X.2017.06.001]
　GUAN Yu-guang,YU Si-ke,LIU Chang-qing,et al.Stereotatic EEG-guided radio-frequency thermocoagulation of epileptogenic zones in the patients with refractory epilepsy[J].,2017,(03):369.[doi:10.13798/j.issn.1009-153X.2017.06.001]
[3]杜秀玉 综述　栾国明 审校.大脑半球切除术后脑可塑性的研究进展[J].中国临床神经外科杂志,2017,(06):391.[doi:10.13798/j.issn.1009-153X.2017.06.008]
[4]陈俊喜　郭　强　谭红平　王艮波　华　刚.ROSA引导下立体定向脑电图在儿童难治性癫痫手术中作用[J].中国临床神经外科杂志,2017,(09):623.[doi:10.13798/j.issn.1009-153X.2017.09.005]
　CHEN Jun-xi,GUO Qiang,TAN Hong-ping,et al.Application of ROSA-guided stereoelectroencephalography surgery for intractable epilepsy in children[J].,2017,(03):623.[doi:10.13798/j.issn.1009-153X.2017.09.005]
[5]王逸鹤　赵国光　单永治　樊晓彤　安　阳　卢　超.局灶性皮质发育不良致药物难治性癫痫的手术预后及其影响因素[J].中国临床神经外科杂志,2017,(11):737.[doi:10.13798/j.issn.1009-153X.2017.11.001]
　WANG Yi-he ZHAO Guo-guang,SHAN Yong-zhi,FAN Xiao-tong,et al.Analysis of factors related to postoperative prognoses in focal cortical dysplasia patients with refractory epilepsy[J].,2017,(03):737.[doi:10.13798/j.issn.1009-153X.2017.11.001]
[6]徐德辉　谢海涛　伍犹梁　谢学敏　余佳彬　张晓静　隋立森　赵　敏.脑灰质异位合并巨脑回及海马硬化致药物难治性癫痫1例[J].中国临床神经外科杂志,2019,(01):64.[doi:10.13798/j.issn.1009-153X.2019.01.022]
[7]田海港　郭效东　王本瀚.迷走神经刺激术对药物难治性癫痫病人胃肠道功能的影响[J].中国临床神经外科杂志,2020,(02):103.[doi:10.13798/j.issn.1009-153X.2020.02.014]
[8]谭红平　郭　强　华　刚　陈俊喜　唐晓伟　陈淼彬　朱　丹.胚胎发育不良性神经上皮肿瘤继发癫痫的外科治疗[J].中国临床神经外科杂志,2021,26(01):8.[doi:10.13798/j.issn.1009-153X.2021.01.003]
　TAN Hong-ping,GUO Qiang,HUA Gang,et al.Surgical treatment of patients with epilepsy due to dysembryoplastic neuroepithelial tumors[J].,2021,26(03):8.[doi:10.13798/j.issn.1009-153X.2021.01.003]
[9]韩彦明　沈云娟　史　哲　刘亚丽　杨宝慧　王天成　张新定.神经节细胞胶质瘤相关癫痫的外科治疗[J].中国临床神经外科杂志,2021,26(07):505.[doi:10.13798/j.issn.1009-153X.2021.07.003]
　HAN Yan-ming,SHEN Yun-juan,SHI Zhe,et al.Surgical treatment for patients with ganglioglioma-related epilepsy[J].,2021,26(03):505.[doi:10.13798/j.issn.1009-153X.2021.07.003]
[10]陈思畅　单永治　赵国光.激光间质热疗在脑部疾病治疗中的应用现状[J].中国临床神经外科杂志,2021,26(08):637.[doi:10.13798/j.issn.1009-153X.2021.08.021]
[11]江洪祥　陈谦学.神经调控技术在药物难治性癫痫治疗中的应用进展[J].中国临床神经外科杂志,2021,26(08):644.[doi:10.13798/j.issn.1009-153X.2021.08.023]

更新日期/Last Update: 2017-03-25