机器人辅助双侧丘脑底核脑深部电刺激植入术治疗老年帕金森患者的效果观察

Observation on effect of robot-assisted bilateral subthalamic nucleus deep brain stimulation implantation in treatment of elderly patients with Parkinson's disease

目的观察机器人辅助双侧丘脑底核脑深部电刺激植入术(STN-DBS)治疗老年帕金森患者的效果。方法选择2021年10月—2023年10月本院收治的86例老年帕金森患者作为研究对象,通过红黄双色球法分成传统组和研究组两组,每组各43例。传统组行STN-DBS治疗,研究组行机器人辅助STN-DBS治疗。比较两组临床疗效和并发症发生情况,术前及术后6个月的帕金森病情状况,心理社会适应能力、睡眠状况和非运动症状,神经因子水平。结果研究组(95.35%)比传统组(79.07%)的总有效率更高(P<0.05)。术后6个月两组帕金森病量表(UPDRS)评分均有效降低,且研究组降低幅度更大(P<0.05)。术后6个月两组心理社会适应量表(PAS)评分均有所提升,且研究组提升幅度更大;帕金森病睡眠量表-2(PDSS-2)、非运动症状量表(PD-NMSS)评分均有效降低,且研究组降低幅度更大(P<0.05)。术后6个月两组乙酰胆碱(Ach)水平均有效降低,且研究组降低幅度更大;胶质细胞源性神经营养因子(GDNF)、脑源性神经营养因子(BDNF)、神经生长因子(NGF)水平均有所提升,且研究组提升幅度更大(P<0.05)。研究组(2.33%)比传统组(20.93%)的并发症发生率更低(P<0.05)。结论机器人辅助STN-DBS治疗老年帕金森患者效果更好,明显改善其术后6个月的帕金森病情状况,心理社会适应能力、睡眠状况和非运动症状及神经因子水平,且安全性较高。

Objective To observe the effects of robot-assisted bilateral subthalamic nucleus deep brain stimulation(STN-DBS)on elderly patients with Parkinson's disease.Methods A total of 86 elderly patients with Parkinson's disease admitted to the First Affiliated Hospital of Henan University from October 2021 to October 2023 were enrolled as study subjects.They were divided into a traditional group(43 cases)and a study group(43 cases)using the red and yellow color method.The traditional group received STN-DBS treatment,while the study group received robot-assisted STN-DBS treatment.Clinical efficacy,complications,Parkinson's disease status before and 6 months after surgery,psychosocial adaptability,sleep status,non-motor symptoms,and neural factor levels were compared between the two groups.Results The total effective rate in the study group(95.35%)was higher than that in the traditional group(79.07%)(P<0.05).At 6 months post-operation,UPDRS scores in both groups were significantly reduced,with a greater decrease in the study group(P<0.05).Psychosocial Adaptability Scale(PAS)scores improved in both groups at 6 months post-operation,with greater improvement in the study group.Scores on the Parkinson's Disease Sleep Scale-2(PDSS-2)and the Parkinson's Disease Non-Motor Symptoms Scale(PD-NMSS)were significantly reduced in both groups,with greater reductions in the study group(P<0.05).Acetylcholine(Ach)levels were significantly decreased at 6 months post-operation,with a greater decrease in the study group.Levels of Glial Cell-Derived Neurotrophic Factor(GDNF),Brain-Derived Neurotrophic Factor(BDNF),and Nerve Growth Factor(NGF)were all increased,with greater increases in the study group(P<0.05).The study group(2.33%)had a lower incidence of complications compared to the traditional group(20.93%)(P<0.05).Conclusions Robot-assisted STN-DBS shows a more significant effect in the treatment of elderly patients with Parkinson's disease,with notable improvements in Parkinson's disease status,psychosocial adaptability,sleep status,non-motor symptoms,and neural factor levels at 6 months post-surgery,and is associated with high safety.