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目的评估迷走神经刺激对癫痫患者生活质量的影响。方法 14例药物难治性全身性癫痫患者进行迷走神经刺激术治疗,比较其术前及术后癫痫患者生活质量量表-31(QOLIE-31)评分的变化。结果平均随访12月,患者发作频率平均减少61.0%,其中5例发作频率减少<50%,6例发作频率减少≥50%,3例发作停止。癫痫患者生活质量量表总分从术前的50.5上升至术后的57.1,平均增加6.6(P=0.0276)。各个分量表中得分均有一定程度增加,其中认知功能、情绪两项改善有统计学意义。癫痫患者生活质量量表总分及7个分量表得分改善与发作减少均无相关性。结论迷走神经刺激是一种治疗药物难治性癫痫安全、有效的方法。其作用不仅体现在癫痫发作的减少,对生活质量也有一定的改善作用。而且这两者之间无相关性,提示生活质量改善是迷走神经刺激独立的临床疗效评价指标之一。
Objective To evaluate the effect of vagus nerve stimulation on quality of life in patients with epilepsy. Methods Fourteen patients with drug-refractory generalized epilepsy were treated with vagus nerve stimulation. The QOLIE-31 scores of patients with epilepsy before and after surgery were compared. Results The average follow-up of December was 61.0%. The frequency of seizure was reduced by 50% in 5 patients, the frequency of seizures was reduced by 50% in 6 patients, and the onset of seizures in 3 patients was stopped. The total score of quality of life in patients with epilepsy rose from 50.5 before surgery to 57.1 after surgery, with an average increase of 6.6 (P = 0.0276). Scores in all subscales increased to some extent, of which cognitive function and emotional improvement were statistically significant. There was no correlation between the total score of quality of life in epilepsy patients and the improvement of scores of 7 subscales. Conclusion Vagus nerve stimulation is a safe and effective method for the treatment of refractory epilepsy. Its role is not only reflected in the reduction of seizures, the quality of life also has some improvement. And there is no correlation between the two, suggesting that improving the quality of life is one of the indicators of clinical evaluation of vagal nerve stimulation independent.