双侧丘脑底核慢性电刺激治疗原发性帕金森病

Treatment of idiopathic Parkinson′s disease with chronic electronic deep brain stimulation of bilateral subthalamic nucleus

目的探讨双侧丘脑底核-脑深部电刺激(STN-DBS)治疗原发性帕金森病(PD)的手术方法及临床疗效。方法采用头颅核磁共振及术中微电极记录电生理技术明确靶点定位,对14例原发性PD患者行STN-DBS手术。随访6个月-8年,评估手术对患者运动症状的改善及术后6个月患者服药剂量减少情况。结果术后6个月患者统一用帕金森评分量表(UPDRS),运动检查评分有明显改善(P<0.05):"开"状态下平均改善率为41.8%,"关"状态下平均改善率为51.6%。患者术后通过调整刺激参数及药物剂量,均能获得满意的生活质量。于术后6个月左右评估,患者服用抗帕金森药物剂量平均减少55.6%(P<0.05)。结论 STN-DBS术治疗原发性PD疗效确切。

Objective To evaluate the surgical approaches and clinical efficacy of electronic deep brain stimulation（DBS） in bilateral subthalamic nucleus （STN） for the treatment of Parkinson＇s disease. Methods Fourteen patients with idiopathic Parkinson＇s disease were treated with chronic electronic bilateral subthalamic nucleus deep brain stimulation（STN-DBS）. The target was established by cranial magnetic resonance（MRI） and intraoperative microelectrode recording（MER）. The patients were followed up for 6 months to 8 years. The outcomes of motor symptoms and medication dose in the 6th month after surgery were analyzed. Results The Unified Parkinsonts Disease Rating Scale （UPDRS） motor score was significantly improved in the 6th month after surgery（P^0. 05）. The UPDRS motor score was improved on an average by 41.8% under on-status and 51.6% under oft status. Patients were able to gain a better life quality by a long-term stimulation parameters and medication dose adjustment. The medication dose was reduced averagely by 55.6% in the 6th month after surgery. Conclusion The bilateral subthalamic nucleus stimulation is an effective method for the treatment of idiopathic Parkinsoffs disease.