山东大学齐鲁医院神经外科脑深部电刺激术手术步骤标准化操作流程(SOP)暨核查表

Standard operation procedure and checklist of deep brain stimulation in department of neurosurgery,Qilu Hospital of Shandong University

脑深部电刺激术已经成为治疗中晚期帕金森病外科治疗的金标准,其可以明显地改善PD患者的运动症状,提高生活质量。山东大学齐鲁医院神经外科自2005年开始实施DBS手术,总结DBS手术特点主要有以下几方面:(1)需要熟练掌握Leksell头架、手术计划系统、微电极记录系统等新型手术设备的应用;(2)该手术操作对精度要求极高;(3)手术步骤多,过程较繁琐,任何操作失误都将影响手术效果;(4)除了一个训练有素的神经外科团队,还需要手术室、神经内科、麻醉科、影像科、信息中心通力配合,且各部门工作都将决定手术进程的推进。鉴于DBS手术的特点,结合国内外学者制定的神经外科手术核查表的经验,提出并初步实践了DBS手术步骤标准化操作流程(SOP)暨核查表。

Deep brain stimulation （ DBS ） has become the gold standard for surgery of middle and late stage Parkinson＇s disease （PD）, which can significantly improve the motor symptoms and improve the quality of life for patients with PD. The Department of Neurosurgery of Qilu Hospital of Shandong University started DBS surgery in 2005 and have accumulated rich experiences. The authors summed up DBS operation characteristics as followed： （1） The surgeons need to have a good mastery of Leksell headstock, operation planning system, microelectrode recording system and so on. （2） The operation requires high precision. （3） The surgery has complicated steps and process so that any misoperation could affect operation outcome. （4） Except for a well-trained neurosurgery team, cooperation from the operation room, departments of neurology, anesthesiology and radiology is essential, and any departinent involved decides the process of operation. Based on the characteristics of DBS operation, refering to the experience from domestic and foreign scholars, the authors formulated and initially practised the standard operation procedure （SOP） as well as the checklist of deep brain stimulation surgery.