【摘要】 目的:分析皮质电脑监测下手术治疗颅内结构性损害伴癫(EP)发作的临床实用价值。方法:采用四川智能公司ECoG监测仪,术前、术中、术后将8根银球状电极,按单双数分成两组,置于暴露的脑域上或用条状及网络状硅橡胶电极,将电极放置在手术野皮质表面,将每个脑回逐个仔细探测,记录,寻找EP放电灶,然后将不同部位的波仔细比较,确定原发灶和继发灶,标明记号,显微镜下将病变切除后再行ECoG检查,寻找致灶。灶切除首先从波最明显处开始,如此反复,直至于术野内棘波等病灶清除为止。结果:32例患者,ECoG监测均有样放电,其中棘波、棘-慢综合波22例,尖-慢综合波6例,棘波、尖波混合放电4例,阳性率100%。术后,患者抽搐倒地等症状28例消失,4例偶有发作,但持续时间较前明显缩短,1～2min缓解,逐渐自行恢复如常。全部病例生活均能自理,28例患者能重返自己的工作、学习岗位及从事力所能及的劳动。结论:ECoG术前、术中、术后监测定位是进一步确定灶和手术切除范围的重要依据,也是提高手术质量的关键。更多还原

【Abstract】 Objective:To analyse the clinical applied value of operative treatment on cerebral structural lesion with epilepsy(EP) under monitoring of electrocorticogram.Methods:in adopting of ECoG montior of Sichuan Inteligent Co.Ltd,divide 8 silver spherical electrodes into 2 groups according to odd and even numbers and place them on the exposed brain field before,during and after operation or place the strip or mesh silastic electrode on the surface of cortex,carefully detect,record each gyrus one by one and find out the EP focal discharge,then carefully compare the epilepsy waves in different parts,affirm primary focus and secondary focus,indicate the mark clearly,cut the pathological changes under the microscope,then implement ECoG check-up and look for epileptogenic focus.Start cutting the epileptic focuses from the part where has the most obvious epileptic wave,repeat it again and again until the spike wave and other focus in operation are cleared away. Results:In 32 patients,there are epileptic discharge under the monitor of ECoG,22 cases were spike wave and spike-slow wave complex,6 cases were sharp slow wave complex,4 cases were spike and sharp wave blending discharge,positive rate is 100%.After operation,in 28 patients,twitching,falling and other symptoms disappeared,4 patients occasionally seizure,but the lasting time shortened obviously than the past,1～2min relieved and gradually recover as normal.All the patients can take care of themselves,28 patients can return to their work,study and do their job in their power. Conclusions: ECoG monitor and locating before,during and after operation is an important base in further affirming the epileptic focus and operative cutting scale and also is key in improving the quality of operation.更多还原