浅析癫痫手术是否一劳永逸.doc

Analysis of epilepsy surgery whether once and for all（浅析癫痫手术是否一劳永逸）In patients with epilepsy, you want to take a few patients with surgical treatment of epilepsy. The reason, they believe that surgery can be once and for all, you can quickly get rid of the troubled years of epilepsy, and also do not have endless medicine, why not.在癫痫的患者中，想要采取癫痫手术治疗的患者不在少数。究其原因，他们认为手术治疗可以“一劳永逸”，可以快速摆脱多年癫痫疾病的困扰，也不用无休止吃药，何乐而不为。In response to this phenomenon, the experts pointed out: for the surgical treatment of epilepsy, and is not suitable for all patients with satisfactory results, but on the part of patients with refractory epilepsy. That surgery to once and for all idea to solve all the problems is unrealistic.针对这种现象，专家指出：对于癫痫手术治疗，并不适合所有的患者，但对一部分难治性癫痫患者有满意的效果。认为手术治疗能够“一劳永逸”，解决所有问题的想法是不现实。According to related statistics, through formal treatment, about 80% of patients can completely control seizures, and under the guidance of a doctor, by improving the physical fitness of patients with epilepsy and change within the environment of the patients body, such as: to correct the patients immune disorders, the central neurotransmitter steady-state balance, relieve brain abnormal nerve cell gap junction abnormal synchronous discharge avoid epileptogenic substances into the brain induce epileptic, etc., 3-5 years, if not attack, in close coordination with the doctor undergradually reduce the dosage, withdrawal, to avoid leakage medication or self-medication in withdrawal. Another part of refractory epilepsy or intracranial lesions of patients can be treated surgically.据相关统计资料显示，通过正规治疗，大约80%的患者可以完全控制发作的，并在医生的指导下，通过改善患者的癫痫体质，改变了患者体内的内环境，如：纠正患者免疫的紊乱，中枢神经递质的稳态平衡，解除脑内异常的神经细胞缝隙连接而导致的异常同步放电，避免致痫物质入脑诱发癫痫等，若3-5年不发作，与医生密切配合下可逐渐减药、停药，切忌漏服药或自行减药、停药。另有一部分难治性癫痫或颅内有病灶的病人可进行手术治疗。Not all epilepsy patients are able to undergo surgery, only a small portion of patients suitable for surgery. On the one hand, a lot of the type of epilepsy, such as idiopathic epilepsy, because the right drug treatment or Chinese medicine treatment can be well controlled, and unnecessary surgery. On the other hand, many of the type of epilepsy such as generalized epilepsy there is no focal abnormalities, surgery can not be carried out, or surgical treatment poorly, not suitable for surgical treatment.不是所有的癫痫患者都能够接受手术，适合手术治疗的仅仅是一小部分患者。一方面，很多的癫痫类型例如特发性癫痫，因为采用正确的药物治疗或中医治疗就能够控制良好，而不必要进行手术治疗。另一方面，许多癫痫类型如全面性癫痫不存在局灶性的异常，无法进行手术治疗，或者手术治疗效果很差，也不适合手术治疗。Clinical meet the standard of refractory, the pulse ended epilepsy therapy exclude physical therapy, enter the surgical positioning Assessment program. The assessment procedure of the surgery is very complex and requires multiple checks jointly analyze the results. Difficult to reach the same conclusion if the number of checks, as well as the results of the inspection found multiple trigger epileptic area to trigger epileptic area is located in important functional areas, patients may not be suitable for surgery.如果患者临床符合难治性的标准，排除采用物理治疗的脉冲止痫疗法，则进入手术定位评估的程序。手术的评估程序很复杂，需要多个检查综合共同分析得出结果。如果多项检查难以得出一致的结论，以及检查的结果发现存在多个引发癫痫的区域或者引发癫痫的区域位于重要的功能区，那么患者可能不适合于手术治疗。The choice of surgical approach: There are a variety of surgical way to select specific needs based on the patients condition. The most mature, but also the most craniotomy direct removal of the epileptic focus.外科手术方式的选择：目前存在多种外科手术方式，需要根据患者的情况具体选择。现在最为成熟，也是采用最多的是开颅手术，直接切除癫痫病灶。Surgical treatment of epilepsy is not once and for all, it is not high security, the surgery involves the need to be cautious when to head, many neurologists and make unremitting efforts for the positioning of the epileptic focus, but surgery may still be importantthe brain function generated damage may appear similar stroke hemiplegia, aphasia dysfunction.但是手术治疗癫痫并非一劳永逸，也并不是高保障的，手术牵涉到头颅时需要慎之又慎，许多神经科医生都在为癫痫灶的“定位”而不懈努力，但术中仍有可能对重要的脑功能区产生损害，可能出现类似脑中风的偏瘫、失语等各种功能障碍。Epilepsy surgery and need some time to maintain the anti-epileptic drugs, consolidation therapy. Even if the surgery is very successful, and also need to take anti-epileptic drugs. Epilepsy surgery is the in epilepsy long-term course of treatment of a period.癫痫外科手术后均需要一定时间的抗癫痫药物维持、巩固治疗。即使手术非常成功，也需要服用抗癫痫药物。癫痫手术治疗是癫痫长期治疗过程中的一段时期。Needs of early drug treatment after surgery due to surgical stimulation of the cerebral cortex and the anti-epileptic drug concentration fluctuations in the blood caused by surgery may even seizures in status epilepticus, and it shall be given an anti-epileptic drug treatment, patients should be immediatelymedication. Long-term treatment of post-operative control may be residual epileptogenic zone attack potential of the cortex (such as the stimulation area) development of the epileptogenic zone, prevention, prevention and treatment of surgical scarring epileptogenic zone. Leaving only a precursor to the onset of the patient, according to the frequency of attacks, duration, and impact, reference EEG can be considered to reduce the dosage according to the disease, at le