摘要
目的 评价品驰脑起搏器对帕金森病（PD）的临床治疗效果和安全性。方法 回顾性分析武警后勤学院附属医院脑科中心自2013年1月至2016年6月通过植入品驰脑起搏器系统治疗的49例PD患者的临床资料。所有患者均行丘脑底核（STN）电极植入。应用统一帕金森评估量表（UPDRS）第Ⅱ部分（运动评分）、第Ⅲ部分（日常生活活动）和39项帕金森生存质量调查问卷（PDQ-39）对患者术前、术后3个月及术后1年进行评分，同时记录手术相关并发症。结果 36例患者行双侧电极植入，13例患者行单侧电极植入，术后复查头颅MRI提示所有电极均精确地置于STN内。49例患者术后均获随访，症状均得到改善。术后3个月的UPDRS Ⅱ、UPDRS Ⅲ评分以及PDQ-39评分分别为（10.21±5.28）分、（18.30±8.11）分、（32.94±15.07）分，与术前评分[（14.37±6.24）分、（26.82±14.75）分和（43.76±17.42）分]相比明显降低，差异均有统计学意义（P〈0.05）。术后1年的各项评分分别为（9.65±4.88）分、（16.96±9.97）分和（30.16±10.15）分，与术后3个月相比差异均无统计学意义（P〉0.05）。所有患者均未出现与起搏器硬件系统和电刺激相关的并发症。结论 品驰脑起搏器能修复PD患者的神经功能，明显改善其运动症状、日常生活能力和生存质量，且无明显并发症。
Objective To evaluate the curative efficacy and safety of PINS deep brain stimulation （DBS） for Parkinson＇s disease.Methods A retrospective study was conducted of the 49 patients with Parkinson＇s disease who had been subjected to the PINS DBS surgery from January 2013 through June 2016 at our department. They were 23 males and 26 females, aged from 40 to 77 years （average, 63.2 years）. There were 36 cases of bilateral disease and 13 ones of unilateral disease. They all received implantation of subthalamic nucleus （STN） electrode for PINS DBS. The Unified Parkinson＇s Disease Rating Scale （UPDRS） Ⅱ/Ⅲ and the 39-item Parkinson＇s Disease Questionnaire （PDQ-39） were used for assessment of each patient preoperation, 3 months and one year postoperation. The operation-associated complications were recorded.Results Thirty-six patients underwent bilateral electrode implantation and 13 unilateral electrode implantation. The head MRI follow-ups showed that all the electrodes were accurately placed in the STN. Follow-ups also showed that the symptoms were improved in all cases. The UPDRS Ⅱ/Ⅲ and PDQ-39 scores at 3 months after operation were respectively 11.71±5.28, 18.30±8.11 and 32.94±15.07, significantly lower than the values before DBS （14.37±6.24, 26.82±14.75 and 43.76±17.42, respectively） （all P〈0.05）. The UPDRS Ⅱ/Ⅲ and PDQ-39 scores at one year postoperation were respectively 9.65±4.88, 16.96±9.97 and 30.16±10.15, showing no significant differences from the values at 3 months after operation （P〉0.05）. Complications were not present associated with pacemaker hardware, system or electrical stimulation.Conclusions PINS DBS may repair the neurological function in patients with Parkinson＇s disease, obviously ameliorating their symptoms of movement disorder, living ability and life quality. The operation is safe, leading to no obvious complications. Regular modulation of the stimulation parameters assure stable curative efficacy.
作者
陈以胜
李强
李建国
陈宝友
张赛
Chen Yisheng;Li Qiang;Li Jianguo;Chen Baoyou;Zhang Sai(Neurosurgery Department, Brain Center, Affiliated Hospital to Logistics College of Chinese People＇s Armed Police Force, Tianjin 300162, China)
出处
《中华神经医学杂志》
CAS
CSCD
北大核心
2018年第4期371-375,共5页
Chinese Journal of Neuromedicine
基金
国家重点研发计划项目子课题（2016YFC0105901WHC）
关键词
脑深部电刺激
帕金森病
丘脑底核
Deep brain stimulation
Parkinson＇s disease
Subthalamic nucleus
