不同术式对颞叶癫痫患者术后认知功能、记忆能力以及生活质量的影响

目的:探讨不同术式对颞叶癫痫患者术后认知功能、记忆能力以及生活质量的影响。方法:选取2014年2月～2018年4月期间我院收治的103例颞叶癫痫患者为研究对象,根据随机数字表法将患者分为单侧前颞叶切除术(ATL)组(n=51,给予ATL治疗)和选择性海马杏仁核切除术(SAH)组(n=52,给予SAH治疗),比较两组患者的手术疗效、术后认知功能、记忆能力、生活质量以及并发症。结果:两组术后6个月临床总有效率比较差异无统计学意义(P0.05)。两组患者术后6个月生活质量量表各项评分均较术前升高(P0.05)。两组患者术后6个月总智商(FIQ)、语言智商(VIQ)评分均较术前升高,且SAH组高于ATL组(P0.05)。两组术后6个月优势半球侧记忆商数(MQ)评分降低,非优势半球侧MQ评分升高(P0.05);SAH组术后6个月非优势半球侧MQ评分高于ATL组(P0.05)。两组患者术后并发症发生率比较无统计学差异(P0.05)。结论:颞叶癫痫患者采用ATL、SAH术式治疗,可获得相似的治疗效果,安全性均较好,但SAH术式在保护患者的认知功能及记忆能力方面更优。

Effects of Different Surgical Methods on Cognitive Function, Memory Ability and Quality of Life in Patients with Temporal Lobe Epilepsy after Operation

ABSTRACT Objective: To investigate the effects of different surgical methods on cognitive function, memory ability and quality of life in patients with temporal lobe epilepsy after operation. Methods: 103 patients with temporal lobe epilepsy who were admitted to our hospital from February 2014 to April 2018 were selected as the study subjects. According to the random number table method, the patients were divided into two groups: unilateral anterior temporal lobectomy (ATL) group (n=51, given ATL treatment) and selective hippocampal amygdalactomy (SAH) group (n=52, given SAH treatment). The operative effect, cognitive function, memory ability, quality of life and complications were observed. Results: There was no significant difference in the total effective rate between the two groups at 6 months after operation (P>0.05). The scores of QOL in the two groups at 6 months after operation were higher than those before operation (P<0.05). The total intelligence quotient (FIQ) and language intelligence quotient (VIQ) scores of the two groups at 6 months after operation were higher than those before operation, and SAH group was higher than ATL group(P<0.05). The MQ scores of dominant hemisphere side were lower and the MQ scores of non-dominant hemisphere side were higher in SAH group than in ATL group at 6 months after operation(P<0.05). There was no significant difference in the incidence of postoperative complications between the two groups (P>0.05). Conclusion: The treatment of temporal lobe epilepsy with ATL and SAH can achieve similar therapeutic effect and better safety, but SAH is better in protecting cognitive function and memory ability of patients.