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目的探讨外科治疗对难治性颞叶内侧癫痫患者短期内的项目记忆及源记忆的影响。方法对18例诊断为难治性颞叶内侧癫痫患者,行选择性海马杏仁核切除术(其中左侧7例,右侧11例),并在手术前及手术后3个月选用实义词和实物简图分别进行项目记忆和源记忆测试,对结果进行分析。结果所有患者随访3～12个月,平均6.78个月,疗效满意13例(72.2%),显著改善4例(22.2%),良好1例(5.6%);颞叶内侧癫痫患者手术治疗前和术后3个月的项目记忆指标值分别为0.7609±0.1225和0.6296±0.1313,源记忆指标值分别为0.7384±0.1369和0.6806±0.1533,差异均有统计学意义(P<0.05)。左侧患者手术治疗前和术后3个月的项目记忆指标值分别为0.7576±0.0763和0.6580±0.0834,源记忆指标值分别为0.7024±0.1432和0.5952±0.1950,差异均有统计学意义(P<0.05)。右侧患者手术治疗前和术后3月的项目记忆指标值分别为0.7631±0.1483和0.6116±0.1556,差异有统计学意义(P<0.05),而源记忆指标值分别为0.7614±0.1345和0.7348±0.0937,差异无统计学意义(P>0.05)。结论外科治疗难治性颞叶内侧癫痫效果满意,短期内可能会造成患者的项目记忆和源记忆损害,特别是对左侧手术患者的影响较大,而对右侧手术患者的影响主要表现为项目记忆损害。
Objective To investigate the effect of surgical treatment on the temporal memory and source memory of patients with intractable temporal lobe medial epilepsy. Methods Eighteen patients with intractable temporal lobe medial epilepsy underwent selective hippocampal amygdalotomy (including 7 cases on the left and 11 cases on the right), and the real word and The physical diagram respectively project memory and source memory test, the results were analyzed. Results All patients were followed up for 3 ~ 12 months with an average of 6.78 months. Thirteen patients (72.2%) were significantly improved, 4 (22.2%) were significantly improved, and 1 patient (5.6%) was significantly better. The patients with temporal lobe medial epilepsy The items of memory at 3 months postoperatively were 0.7609 ± 0.1225 and 0.6296 ± 0.1313, respectively. The values of source memory index were 0.7384 ± 0.1369 and 0.6806 ± 0.1533, respectively (all P <0.05). The items of memory of the left patients before and 3 months after surgery were 0.7576 ± 0.0763 and 0.6580 ± 0.0834, respectively. The source memory indexes were 0.7024 ± 0.1432 and 0.5952 ± 0.1950, respectively (all P < 0.05). The items of memory of the right patients before and after surgery were 0.7631 ± 0.1483 and 0.6116 ± 0.1556, respectively, with statistical significance (P <0.05), while the values of the source memory index were 0.7614 ± 0.1345 and 0.7348 ± 0.0937, the difference was not statistically significant (P> 0.05). Conclusion Surgical treatment of intractable temporal lobe medial epilepsy with satisfactory results in the short term may cause the patient’s memory of the project and the source of memory, especially in patients with a greater impact on the left, while the right surgical patients mainly as Item memory damage.