目的 比较海马横切术与选择性海马杏仁核切除术对顽固性颞叶内侧型癫疒间病人的治疗效果及其对认知、记忆功能的影响.方法 回顾性分析19例顽固性颞叶内侧型癫疒间病人的临床资料,其中8例采用海马横切术(观察组),11例采用选择性海马杏仁核切除术(对照组).分析比较两组病人的术后癫疒间控制率以及手术前后神经心理学检查结果 .结果两组术后癫疒间控制率无明显统计学差异(P>0.05).观察组手术前后操作智商(performance intelligence quotient,PIQ)、语言智商(verbal intelligence quotient,VIQ)、总智商(full intelligence quotient,FIQ)、记忆商(memory quotient,MQ)均无统计学差异(P>0.05).对照组病人术后PIQ、FIQ、MQ均明显低于术前(P<0.05),两组病人在手术前后MQ差值方面的差异有统计学意义(P<0.05).结论 海马横切术可有效控制癫疒间发作,同时对病人神经心理学功能无明显损害,尤其可以较好地保留病人的记忆功能.%Objective To compare the surgical outcome and its influences on cognition and memory of hippocampal transection and selective amygdalohippocampectomy for intractable medial temporal lobe epilepsy. Methods Clinical data of 19 patients with intractable medial temporal lobe epilepsy were analyzed retrospectively, including 8 patients receiving hippocampal transection (observation group) and 11 receiving selective amygdalohippocampectomy (control group). The seizure control rate after surgery and neuropsychological examinations before and after surgery were analyzed and compared. Results There was no significant difference in seizure control rates between two groups (P>0.05). There was no significant difference in performance intelligence quotient (PIQ), verbal intelligence quotient (VIQ), full intelligence quotient (FIQ) and memory quotient (MQ) before and after surgery in observation group (P>0.05). The PIQ, FIQ and MQ after surgery in control group were obviously lower than those before surgery (P<0.05). There was significant difference in MQ differentials before and after surgery between the two groups (P<0.05). Conclusion Hippocampal transection can effectively control seizure, make little damage to the function of neuropsychology and especially can well preserve the memory function.
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