用症状检查表90修订后内侧颞叶癫痫患者皮质杏仁核海马切除术后精神症状的改变

Zhang Guangming MD , Zhou Wenjing MD , Chen Guoqiang MD , Zhu Yan MD , Zhang Fuquan MD , Zuo Huancong MD
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引用次数: 16

摘要

背景:皮质杏仁体海马切除术(前颞叶切除加杏仁体海马切除术)在癫痫手术中很常见。难治性内侧颞叶颞叶患者有时会发生术前和术后精神障碍。我们想通过定量的方法来了解CAH是否对医学TLE患者的精神症状有积极的影响。方法62例合并CAH的内科TLE患者分别在术前和术后1、2年完成3次SCL-90-R问卷调查。计算SCL-90-R组平均GSI得分并进行统计学分析。结果Engel I亚组与Engel II至IV亚组术前平均GSI评分差异无统计学意义。Engel II至IV亚组术后1年、2年GSI平均评分均高于Engel I亚组,差异有统计学意义。其他亚组在不同时间间差异无统计学意义。全组及Engel I亚组术后1年、2年GSI平均评分均低于术前。术后2年全组及Engel I亚组平均GSI评分均低于术后1年。Engel II至IV亚组不同时间GSI平均得分差异无统计学意义。结论经SCL-90-R评估,皮质扁桃体海马切除术可改善TLE患者的精神症状。这种改善与治疗效果有关,与性别、侧位和MRI异常无关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Psychiatric symptom changes after corticoamygdalohippocampectomy in patients with medial temporal lobe epilepsy through Symptom Checklist 90 Revised

Background

Corticoamygdalohippocampectomy (anterior temporal lobe resection plus amygdalohippocampectomy) is common in epilepsy surgery. Pre- and postoperative psychiatric disorders occurred sometimes in patients with refractory medial TLE. We want to know if CAH has an affirmative effect on the psychiatric symptom of patients with medial TLE through a quantitative method.

Methods

Sixty-two patients with medial TLE who had CAH accomplished SCL-90-R questionnaires thrice (presurgical and postsurgical 1 and 2 years). Average GSI scores in SCL-90-R were calculated and statistically analyzed.

Results

There was no statistical difference in the presurgical average GSI scores between Engel I and Engel II to IV subgroup. Postoperative 1 and 2 years' average GSI scores of Engel II to IV subgroup were both statistically higher than those of Engel I subgroup. There were no statistical differences between other subgroups in different time. Postsurgical 1 and 2 years' average GSI scores of the whole group and Engel I subgroup were statistically lower than those of presurgery. Postoperative 2 years' average GSI scores of the whole group and Engel I subgroup were statistically lower than those of postsurgical 1 year. For Engel II to IV subgroup, there were no statistical differences among the average GSI scores in different time.

Conclusion

Corticoamygdalohippocampectomy could improve the psychiatric symptoms of patients with TLE as assessed by the SCL-90-R. This improvement was related to the therapeutic effect and was not related to sex, lateralization, and MRI abnormality.

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Surgical Neurology
Surgical Neurology 医学-临床神经学
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