立体定向选择性Vim核和(或)PVP核毁损术治疗帕金森病疗效观察

Curative effect of stereotactic selective thalamotomy and/or posteroventral pallidotomy for Parkinson's disease

目的观察应用立体定向脑内核团毁损术治疗帕金森病的临床疗效。方法 2012年7至2013年12月采用立体定向丘脑腹中间核(Vim核)和或苍白球腹后外侧部(PVP核)毁损术治疗帕金森病45例。术前、术后1个月进行UPDRS评分,比较手术前后评分的变化和症状改善情况。结果 45例帕金森病患者的肢体震颤、僵硬及运动迟缓均得到明显改善,术后1个月的UPDRS评分较术前明显减少(P<0.01),术后无明显并发症。结论立体定向脑内核团毁损术治疗帕金森病疗效显著,靶点定位、毁损范围及程度与手术疗效及并发症密切相关。

Objective To observe the clinical efficacy of stereotactic intracerebral nucleus damage in the management of Parkinson＇s disease. Methods A total of 45 patients with PD receiv- ing stereotactic thalamotomy and/or posteroventral pallidotomy from July 2012 to December 2013. UPDRS motor scores were assessed before and after one month surgery, and the changes of UPDRS scores and clinical efficacy were compared. Results Tremor rigidity and bradykinesia of all 45 patients were alleviated dstinctly. The score of UPDRS decreased significantly compared with the preoperative after a month（P〈0.01） ,and none complication occurred. Conclusion The curative efficacy of stereotactic intracerebral nucleus damage is good in treatment of PD patients, the target localization and the size and degree of lesion are closely related to the curative effect and the occurrence of complicatins.