摘要
目的总结根据脑深部电刺激术(deep brain stimulation,DBS)电极植入位置和术中电生理信号选择触点进行开机后首次程控的经验。方法分析60例接受DBS的帕金森病(Parkinson’s disease,PD)病例资料,根据DBS术后程控不同,分为研究组30例和对照组30例。对照组采用传统调控法,每个触点均进行调试。研究组根据电极植入位置和术中电生理信号,选择触点进行调试。结果首次调控时间:对照组(120±18)min,研究组(45±16)min,差异具有统计学意义(P <0.0001)。副反应发生率:对照组为60%(18/30),研究组为23%(7/30),差异具有统计学意义(P=0.004)。统一帕金森病评定量表(unified Parkinson’s disease rating scale,UPDRS)-Ⅲ改善率:对照组为48.2%,研究组为50.6%,差异无统计学意义(P=0.1397)。随访12个月,病人平均门诊程控次数:对照组(4.5±2.5)次,研究组(3.0±1.8)次,差异具有统计学意义(P=0.0099)。结论根据电极植入位置和术中电生理信号确定电极触点的程控方法,具有程控时间短、开机副反应少的优点。
Objective To summarize the experience and method of selecting contact points for performing the first time program control after deep brain stimulation(DBS) according to the electrode implantation position and intraoperative electrophysiological signals. Methods The data of 60 Parkinson’s disease(PD) patients undergoing DBS were analyzed, and they were divided into experimental group(n = 30) and control group(n = 30) according to the difference of program controls after DBS operation. The control group adopted the conventional regulation method, and each electrode contact point was selected, combined and parameterized separately. The precision control method was adopted in the experimental group, according to the electrode implantation position and intraoperative electrophysiological signals, electrode contacts were accurately selected for startup and parameter adjustment. Results The starting and debugging time was(120 ± 18) min in the control group and(45 ± 16) min in the experimental group, the difference was statistically significant(P < 0.0001). The incidence of side effects was 60%(18/30) in the control group and 23%(7/30) in the experimental group, the difference was statistically significant(P = 0.004). Unified Parkinson’s disease rating scale(UPDRS)-Ⅲ improvement rate was 48.2% in the control group and 50.6% in the experimental group, the difference was not statistically significant(P = 0.1397). During the 12-month follow-up, the average number of outpatient procedures was(4.5 ± 2.5) times in the control group and(3.0 ± 1.8) times in the experimental group, the difference was statistically significant(P = 0.0099). Conclusions The program control method for determining the electrode contacts according to the electrode implantation position and intraoperative electrophysiological signals has the advantages of short program control time and few side reactions when starting up.
作者
袁立佳
陶英群
金海
巩顺
孙霄
王诗邈
王婷婷
潘赫
王元君
金成一
张廷奎
Yuan Lijia;Tao Yingqun;Jin Hai;Gong Shun;Sun Xiao;Wang Shimiao;Wang Tingting;Pan He;Wang Yuanjun;Jin Chengyi;Zhang Tingkui(Department of Neurosurgery,the General Hospital of Northern Theater Command,Shenyang,Liaoning 110016,China)
出处
《中国微侵袭神经外科杂志》
CAS
2021年第4期159-162,共4页
Chinese Journal of Minimally Invasive Neurosurgery
基金
国家自然科学基金面上项目(编号:81870890)
辽宁省博士科研启动基金计划项目(编号:2020-BS-031)。
关键词
帕金森病
脑深部电刺激术
术后程控
Parkinson’s disease
deep brain stimulation
postoperative programming
