脑深部电刺激术对帕金森病患者流涎的治疗效果

Effect of deep brain stimulation on salivation in patients with Parkinson’s disease

目的探讨脑深部电刺激术(DBS)对帕金森病患者流涎症状的临床治疗效果。方法收集我院2014年1月至2016年1月期间收治的伴有流涎且达到DBS手术标准的帕金森病(PD)患者22例,首先给予丘脑底核(STN)DBS(STN-DBS)治疗。然后采用唾液分泌临床分级(SCS-PD)、统一PD评定量表(UPDRS)分别在术前1周及术后6个月进行评分并进行比较。结果(1)STN-DBS术后6个月,22例患者SCS-PD评分在关期和开期均明显低于术前组,具有显著统计学差异(均P<0.001)。(2)22例患者术后6个月其UPDRSⅡ及Ⅲ评分在关期和开期均分别低于术前组(均P<0.001),差异具有显著意义。(3)随访期间,无明显不良反应。结论DBS在改善临床运动功能的同时,也能显著改善PD患者的流涎症状。

Objective To evaluate the effect of applying Deep Brain Stimulation(DBS)on the treatment of the salivation symptom of Parkinson’s disease(PD).Methods Twenty-two cases of the patients with the salivation symptom were observed from January 2014 to January 2016 in our hospital.The patients were all undertaken bilateral subthalamic nucleus(STN)-DBS surgeries through the observing period.The Sialorrhea Clinical Scale for PD(SCS-PD)and the Unified PD Rating Scale(UPDRS)were applied to grade the therapeutic effects of the STN-DBS treatments for each patient.The scores were graded one week before surgeries and six months after surgeries,respectively,and the results were compared.Results(1)After the STN-DBS operation for six months,the SCS-PD score of 22 patients whenever they were during the"on"state or the"off"state were significantly decreased compared with preoperative group,the differences were statistically signifficant(all P<0.001).(2)The UPDRSⅡand UPDRSⅢscore whenever during"on"state and"off"state 6 months after the STN-DBS surgery were significantly decreased compared with the preoperative group,the differences were statistically signifficant(all P<0.001).(3)There was no obvious adverse reactions detected during the period of follow-up.Conclusion The STN-DBS treatment is useful for improving clinical motor function,the STN-DBS treatment can significantly improve the salivation symptoms for patients with Parkinson’s disease.