丘脑毁损术治疗帕金森病94例报告

Thalamotoray for Treatment of Parkinson's Disease (Report of 94 Cases)

目的 报告94例丘脑毁损术治疗帕金森病的初步结果。方法 用Fischer公司生产的ZD定向仪,在CT扫描直接定位下确定靶点。用N-50射频仪,双极射频针插入并毁损Vim核,温度75℃,时间90s。毁损术后常规行MRI检查。结果 89例一侧毁损,5例双侧毁损。震颤和肌强直缓解率达100％,但对运动迟缓无效。近期复发率6.4％。并发症:癫痫发作1.1％,嘴唇和手指麻木17.0％,暂时的轻度的构音障碍33.0％,一过性呃逆6.3％,运动迟缓加重2.0％。结论 丘脑毁损术治疗帕金森病的震颤和强直有显著效果,它是消除帕金森病震颤的最佳手术选择方式。术后应采用药物治疗在内的综合治疗方案,以减少疾病的复发及进程。

Objective To report the therapeutic results of 94 patients with Parkinson's disease (PD), who had been treated by the thalamotomy. Methods Using the ZD stereotactic system (Fischer Company), we determined the target of lesioning directly under CT scaning. The N-50 RF device was used for lesioning. The bipolar RF needle was then inserted into Vim nucleus slowly and destroyed it at 75C for 90 seconds. All the patients received postoperative MRI examinations to evaluate the outcomes. Results Unilateral thalamotomy was done in 89 cases and bilateral in 5 cases. The overall rrate of tremor and rigidity emission was 100%, but bradykinesia wasn't remitted. Short-term recurrence rate was 6.4%. There appeared some complications after the surgery including epileptic seizure (1.1%), anaesthesia of lips and fingers (17.0%), mild dysarthria (33.0%), transient singulation (6.3%), and deteriorated bradykinesia (2.0%). Conclusions The cardinal symptoms of PD such as tremor and rigidity can be significantly ameliorated by thalamotomy. It may be the best therapeutic option to eliminate the tremor in the patients with PD.