幕上胶质瘤切除后皮层脑电癫痫样放电增多的危险因素分析王超，但炜1，谢延风，石全红，方升，刘福英，姜代芬（400016，重庆，重庆医科大学附属第一医院神经外科）[摘要]目的：探讨皮层脑电(Electrocorticography)监护下幕上胶质瘤切除后癫痫样放电增多的相关因素，寻找导致幕上胶质瘤术后早期癫痫发作的危险因素。方法:回顾性分析我科2006年9月至2011年11月皮层脑电监护下行幕上胶质瘤切除195例的临床资料，根据年龄、性别、术前癫痫史的有无、术前是否预防应用抗癫痫药术、肿瘤是否累及皮层、术前是否伴瘤周水肿、肿瘤切除程度等因素进行分组，通过对组间进行χ2检验、并计算C值(Pearson列联系数)及OR值,探讨上述因素与肿瘤切除后ECoG痫样放电增多的关系。结果：195例患者中肿瘤组织切除后癫痫样放电增多者53例，占27.2%。术前癫痫史、术前应用抗癫痫药物、肿瘤累及皮层、术前瘤周水肿、肿瘤非全切等因素组间经方差分析差异有显著性(P<0.05)，其C值依次增强(P<0.05)。术前癫痫史、肿瘤累及皮层、术前瘤周水肿、肿瘤非全切OR>1，术前应用抗癫痫药OR<1。年龄、性别等因素经方差分析无显著性差异(P>0.05)。结论:术前癫痫史、术前应用抗癫痫药、肿瘤累及皮层、术前瘤周水肿、肿瘤非全切与幕上胶质瘤切除后癫痫样放电增多的关联性依次增强；术前癫痫史、肿瘤累及皮层、术前瘤周水肿、肿瘤非全切为危险因素，术前应用抗癫痫药为保护因素。年龄、性别与肿瘤切除后癫痫样放电增多的发生率则无明显相关。[关键词]幕上胶质瘤；皮层脑电；癫痫样放电；危险因素[中图法分类号]R971+6[文献标识码]ATheanalysisofriskfactorsofepileptiformdischargesincreasedunderthesupervisionofElectrocorticographyafterSuperatentorialgliomaresectionWangchao,Danwei,Yanfeng,ShiQuanhong,Fangsheng,LiuFuying,JiangDaifen(DepartmentofNeurosurgery,FirstAffiliatedHospital,ChongqingMedicalUniversity,Chongqing,400016,China)[Abstract]objectiveTostudyrelatedfactorsofepileptiformdischargesincreasedunderthesupervisionofECoGafterSpueratentorialgliomaresection,intendsexploreriskfactorsofacutepostoperativeseizures.MethodsTheclinicaldataof195patients,whoreceivedGliomaresectionundertheguardianshipofECoGinourdepartmentfromSeptember2006toNovember2011,wereanalyzedretrospectively.Basedonage,sex,preoperativeepilepsy,withorwithoutpreoperative1[通讯作者]但炜，E-mail:Dan_Wei@sina.com.cn[基金项目]重庆市卫生局资助面上项目(05-2-167)preventivedrugandtumorinvolvingcortex,withorwithoutpreoperativeperitumoralbrainedemaandtheextentoftumorresection,thesepatientsaregrouped.AnalysetherelationshipbetweenthesefactorsandincreasingofpostoperativeepilepsydischargesthroughChi-SquareTests,Pearson'sproduct-momentcorrelationcoefficientandoddsratio.ResultsPatientswhosepostoperativeepileptiformdischargesareincreasedare53in195cases,accountingfor27.2%.Preoperativeepilepsy,preoperativepreventivedrug,tumorinvolvingcortexandpreoperativeperitumoralbrainedemaandNon-totalresectionoftumoraredifferentsignificantlyinthesegroupsinChi-SquareTests(P<0.05).TheCisinturnenhancing(P<0.05).Relativeriskcoeffientofpreoperativeepilepsy,tumorinvolvingcortexandpreoperativeperitumoralbrainedemaandNon-totalresectionoftumorexceedone,Relativeriskcoefficientofpreoperativepreventivedruglessthanone.FactorssuchasageandsexarenodifferentsignificantlyinChi-SquareTests(P>0.05).Conclusionpreoperativeepilepsy,preoperativepreventivedrug,tumorinvolvingcortex,preoperativeperitumoralbrainedemaandNon-totalresectionoftumorarerelatedofincreasingofpostoperativeepileptiformdischarge,andthehigherofthevalue,thecloserorthecorrelationbetweenvariableandpostoperativeepilepsystronger.Preoperativeepilepsy,tumorinvolvingcorte...