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      2. west china medical publishers
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        find Author "李承俊" 2 results
        • 癲癇的侵襲性術前評估

          癲癇切除手術前精確定位致癇灶至關重要,目前,對于綜合無創性評估仍無法定位致癇灶或區分功能區的患者,國際上常采用硬膜下電極腦電圖監測(Subduralel ectrodes EEG, SDEG)和立體定向腦電圖(SEEG)兩種侵襲性顱內腦電圖(intracranial electroencephalography, iEEG)評估方法進一步定位致癇灶及區分功能區。SDEG 優勢在于其相鄰皮質覆蓋連續性較好、皮層與電極的解剖關系清楚以及功能區定位相對容易;缺點主要在于對深部腦組織覆蓋監測較差、癲癇起源的三維結構難以體現、雙側或相隔較遠的多個區域植入困難以及創傷較大、并發癥比例較高。SEEG 的優點在于定位深部皮質相對容易、癲癇起源的三維結構清楚、微創性高、適合雙側或相隔較遠的多個區域植入;缺點在于相鄰皮質覆蓋連續性較差、功能區定位相對困難、植入過程中可損傷顱內血管導致顱內出血。近年來,iEEG 監測快速發展,但仍需進一步探索,如通過技術的不斷改進及創新實現精確植入電極及降低植入并發癥,通過設計臨床前瞻性研究進一步研究 SDEG 和 SEEG 在定位致癇灶、切除范圍及術后療效的差異等。目前,SDEG 和 SEEG 在術前定位致癇灶方面各有優缺點,臨床上應根據患者的具體情況個體化選擇方案。

          Release date:2020-03-20 08:06 Export PDF Favorites Scan
        • Comparison of the application of two kinds of iEEG monitoring methods (SEEG vs. SDEG) in patients with “difficult to locate” Intractable Epilepsy

          ObjectiveTo explore the advantages and disadvantages of using two intracranial EEG (iEEG) monitoring methods—Subdural ectrodes electroencephalography (SDEG)and Stereoelectroencephalography (SEEG), in patients with “difficult to locate” Intractable Epilepsy. MethodsRetrospectively analyzed the data of 60 patients with SDEG monitoring (49 cases) and SEEG monitoring (11 cases) from January 2010 to December 2018 in the Department of Neurosurgery of the First Affiliated Hospital of Fujian Medical. Observe and statistically compare the differences in the evaluation results of epileptic zones, surgical efficacy and related complications of the two groups of patients, and review the relevant literature. ResultsThe results showed that the two groups of SDEG and SEEG had no significant difference in the positive rate and surgical resection rate of epileptogenic zones, but the bilateral implantation rate of SEEG (5/11, 45.5%) was higher than that of SDEG (18/49, 36.7%). At present, there was no significant difference in the postoperative outcome among patients with epileptic zones resected after SDEG and SEEG monitoring (P>0.05). However, due to the limitation of the number of SEEG cases, it is not yet possible to conclude that the two effects were the same. There was a statistically significant difference in the total incidence of serious complications of bleeding or infection between the two groups (SDEG 20 cases vs. SEEG 1 case, P<0.05). There was a statistically significant difference in the total incidence of significant headache or cerebral edema between the two groups (SDEG 26 cases vs. SEEG 2 cases, P<0.05). There was a statistically significant difference in the incidence of cerebrospinal fluid leakage, subcutaneous fluid incision, and poor healing of incision after epileptic resection (SDEG 14 cases vs. SEEG 0 case, P<0.05); there were no significant differences in dysfunction of speech, muscle strength between the two groups (P>0.05). ConclusionSEEG has fewer complications than SDEG, SEEG is safer than SDEG. The two kinds of iEEG monitoring methods have advantages in the localization of epileptogenic zones and the differentiation of functional areas. The effective combination of the two methods in the future may be more conducive to the location of epileptic zones and functional areas.

          Release date:2020-09-04 03:02 Export PDF Favorites Scan
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          2. 射丝袜