Objective To investigate the efficacy ofvagus nerve stimulation(VNS)in the treatment of refractory epilepsy in children and the key factors affecting its efficacy.Methods The clinical data of 22 children with drug-resistant epilepsy who received VNS treatment in the Second People's Hospital of Hunan Province from January 2016 to April 2023 were analyzed.The average seizure reduction rate,effective rate and McHugh grade were used to evaluate the efficacy of VNS after at least 1 year follow-up.Patients with an attack reduction rate of ≥ 50％were defined as respondents,and Mann-Witney U test andx2test were used,respectively,to conduct univariate and multifactor Logistics regression analysis with statistically significant indicators(P＜0.05).Results Among the 22 patients,the average attack reduction rate was 12.66％at 1 month,26.10％at 3 months,37.47％at 6 months,48.18％at 9 months and 54.38％at 12 months.The effective rate was 5.00％,9.00％,36.00％,50.00％and 68.00％,respectively.12 months after operation,there were 3 cases of grade Ⅰ,12 cases of grade Ⅱ,7 cases of grade Ⅲ,and 0 cases of grade V.Unifactorial and multivariate Logistic regression analysis showed that the curative effect of epilepsy in children was related to the seizure type,among which the curative effect of general seizure was better than that of focal seizure(OR=0.062,P=0.014),and the curative effect of myoclonic seizure and tonic seizure was better than that of other types in general seizure.Conclusion The clinical effect of VNS in the treatment of refractory epilepsy in children is time cumulative,and the surgical effect of myoclonic seizures and tonic seizures in general seizures is better.
维普
万方数据