目的 探讨应用进一步改进的解剖性大脑半球切除术治疗癫痫的远期疗效和对并发症的预防效果.方法 通过对我院接受进一步改进的解剖性大脑半球切除术的43例癫痫进行远期随访,评价治疗效果,分析疗效良好的原因和避免远期并发症的解剖基础.结果 43例均为婴儿偏瘫伴顽固性癫痫,术后随访7 ～ 15年,平均11.3年,癫痫控制满意,完全控制39例(91％),基本控制4例(9％)；术后均无脑表面含铁血黄素沉着症等严重的并发症发生,肢体肌力未减退,痉挛减轻,术后5例患侧大脑半球对应肢体运动功能有短暂轻微的下降,1例出现失语,经治疗均恢复至术前水平.结论 进一步改进的解剖性大脑半球切除术治疗癫痫疗效满意,无严重并发症发生.%Objective To discuss the long-term effects and complications and preventine effect of further improved anatomic hemispherectomy for epileptic patients. Methods The prostecdtive effect of 43 epilepsy patients undergoing anatomic hemi-spherectomy and followed on a long term basis was evaluated, and the cause of the anatomical basis of the curative effect and pre-vention of long-term complications were analyzed. Results All 43 infant patients suffered from hemiplegia with intractable epilepsy, and we were satisfied with the controlling conditions of the epilepsy, including full control of 39 cases (91% ), basic control 4 cases (9% ) in postoperative follow-up of 7 - 15 years, an average of 11.3 years. There were no severe postoperative complications of he-mosiderosis on the brain surfaces and no muscle strength decrease. The spam was alleviated. 5 of them had short and slight decrease of corresponding limb movement function, and aphasia occurred in one patient but he was recovered to preoperative levels after treatment. Conclusion Modified anatomic cerebral hemispherectomy in treatment of epilepsy is effective with no severe complications.
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