【摘要】 目的探讨立体定向脑内核团毁损术及深部电刺激术(DBS)治疗帕金森病的疗效。方法对长期随访的45例接受立体定向核团毁损术和9例接受脑深部电刺激丘脑底核(STN)治疗的帕金森病患者进行疗效评估和临床分析。结果 1例DBS病人术后无效,调整电极后效果满意,射频毁损术及DBS术后短期效果均满意,本组显效47例(87%),有效7例(13%),总有效率100%。日常生活能力(ADL)评分:"开"状态下提高38%,"关"状态下提高49%。统一帕金森病评分量表(UPDRS)评分:"开"状态下症状改善率52%,"关"状态下改善率72%。随访结果:射频毁损者复发率为17.8%,DBS者无复发。结论立体定向脑内核团毁损及深部电刺激术治疗帕金森病疗效满意,精确定位是手术成功的关键,微电极记录可提高手术的准确性。DBS具有非破坏性、可双侧同期手术、术后可调节等优点,但价格昂贵。更多还原

【Abstract】 Objective To observe curative efficacy of stereotaxic ablative surgery and deep brain stimulation(DBS)in the treatment of Parkinson’s disease(PD).Methods Complete follow-up data were analyzed in 45patients who underwent stereotactic intracerebral nucleus lesion and 9patients who underwent deep brain stimulation.Results One case who was underwent DBS is invalid in operation,but the result was satisfactory after adjusting microelectrode.The shortterm effects after stereotaxic ablative surgery and DBS were both satisfied.47cases were significant(87%),7were effective(13%),the rate of significant plus effective was 100%.Ability of Daily Living Questionnaire(ADL)score:of the 54cases,during the"on"and"off"states,symptoms improved by 38% and 49%,respectively.Unified Parkinson’s Disease Rating Scale(UPDRS)score:of the 54cases,during the"on"and"off"states,symptoms improved by 52% and 72%,respectively.The recurrence rate was 17.8% of the patients with stereotactic intracerebral nucleus lesion and none patient of DBS recurred by followed up in 0.5~7years.Conclusion The curative efficacy of stereotaxic ablative surgery and DBS is satisfactory in treatment of PD patients.Precise positioning is essential to surgical results and microelectrode recording can improve the accuracy of surgery.DBS has advantages of non-destructive,bilateral nucleus with synchronical surgery,and postoperative adjustable.But it also owns the defect of expensive price.更多还原