摘要
目的通过丘脑底核(STN)脑深部高频电刺激(DBS)治疗的11例帕金森病(PD)患者手术前后情况对比,初步探讨其近期的疗效和安全性。方法本院2013年7月至2014年9月STN-DBS治疗的11例(双侧9例,单侧2例)原发性PD患者,采用MRI、微电极记录(MER)技术和术中测试共同确定靶点,同期植入脉冲发生器,术后复查头颅CT,分别在术前、术后未开机第3天、开机后3月、6月、12月和15月采用UPDRS评分评估PD患者"开/关"两种状态下的运动症状改善程度、运动并发症、嗅觉改善和左旋多巴类药物减少情况。结果电极植入靶点均为STN,术后早期全部出现微毁损效应,1侧出现电极移位,1例有一过性复视,无硬件相关并发症,开机后12个月时程控参数达到稳定,症状改善达到最优,以震颤(达84.8%)、僵直改善最为明显,平衡障碍改善最差(为49.8%)。结论丘脑底核高频电刺激治疗PD近期疗效显著,术后并发症少。
Objective To study the subthalamic nuclei （STN） high frequency deep brain stimulation（DBS） for the 11 cases of Parkinson＇s disease （PD） and compare before and after surgery in patients with PD, discussed the recent efficacy and safety.Methods from July 2013 to September 2014 the STN-DBS treatment of 11 cases （including 9 cases of bilateral and 2 cases of unilateral ） of idiopathic Parkinson＇s disease, through magnettic resonance imaging （ MRI ）, microelectrode recording （ MER ） technology and intraoperative test, target was identified, at the same time pulse generator was implanted, the CT postoperatively, respectively at the preoperative and postoperative 3 days without opening, after of 3 months, 6 months, 12 months and 15 months, the UPDRS score was evaluated the movement symptoms, movement complications, the sense of smell and levodopa dosage situation under two kinds of state ＂on/off medication ＂.Results All implanted targets was STN, and in early postoperative all cases had micro-damage effect, one electrode displacemented, 1 case with transient diplopia, no hardware related complications happened, after 12 months parameter stabilized and symptoms improved.Conclusion STN-DBS treatment of PD patients is significant effect and high safety.
出处
《脑与神经疾病杂志》
2015年第4期265-269,共5页
Journal of Brain and Nervous Diseases
基金
河北省医学适用技术跟踪项目(GL2014021)
关键词
帕金森病
丘脑底核
脑深部电刺激
Parkinson disease
Subthalamic nuclei
Deep brain stimulation
