帕金森病脑深部电刺激术后远程程控与门诊程控的比较

Comparison of remote and outpatient programming in Parkinson's disease patients after deep brain stimulation

目的:探索帕金森病(PD)脑深部电刺激(DBS)术后患者远程程控的安全性、有效性和经济性。方法:总结2018年6月至2020年6月在武汉大学中南医院神经外科完成DBS术后程控的74例PD患者的临床资料。其中远程组27例,门诊组47例。对两组患者的基本资料、程控效果、不良反应、程控费用及满意度问卷调查结果等进行对比分析。结果:两组患者的基本资料比较差异均无统计学意义,但大多数远程组患者(18/27)来自于距PD中心较远的武汉市以外的地区,而门诊组患者(27/47)则多来自于武汉市(P=0.046)。远程组患者单次程控的费用为300元,而门诊组患者为480(386,870)元(P<0.001)。远程组患者单次程控耗时中位数为30.0(25.0,30.0)min,而门诊组单次程控耗时中位数为210.0(150.0,390.0)min(P<0.001)。满意度问卷调查显示,97.3%(72/74)的患者对手术效果满意,79.7%(59/74)的患者愿意接受DBS术后长期程控,且两组间比较差异无统计学意义;85.2%(23/27)的远程组患者对远程程控满意。4例远程组患者调程控时出现不良反应,均在1周内缓解。结论:PD⁃DBS术后的远程程控安全、有效,降低了DBS术后患者程控的成本,并有较高的患者满意度。

Objective:To explore the safety,effectiveness,and economical efficiency of remote program⁃ming in Parkinson's disease(PD)patients after deep brain stimulation(DBS).Methods:A total of 74 PD patients after DBS were enrolled in this study,who were operated and programmed in the Depart⁃ment of Neurosurgery,Zhongnan Hospital of Wuhan University from June 2018 to June 2020.There were 27 cases in remote group and 47 cases in outpatient group.The basic data,programming effect,adverse reactions,programming cost,and satisfaction were analyzed and compared between the two groups.Results:There was no significant difference in basic data between the two groups,but most patients in the remote group(18/27)lived outside Wuhan far away from the PD center,while most of the patients in the outpatient group(27/47)lived in Wuhan(P=0.046).The cost for each program⁃ming per patient was 300 yuan in the remote programming group,while that was 480(386870)yuan in the outpatient programming group(P<0.001).Single programming consumed 30.0(25.0,30.0)min in the remote group and 210.0(150.0,390.0)min in the outpatient group(P<0.001).Satisfac⁃tion questionnaire showed that 97.3%of the patients satisfied with the operation effect and 79.7%of the patients were willing to accept long⁃term programming after DBS,and there was no difference be⁃tween the two groups.In the remote group,85.2%of patients were satisfied with remote program⁃ming,and only 4 patients had adverse reactions during regulation,which alleviated within 1 week.Conclusion:Remote programming is safe and effective,which can save money and time of Parkin⁃son's disease patients after DBS,with a high degree of satisfaction.