立体定向丘脑腹外侧核毁损治疗帕金森病

Stereotactic Thalamotomy for Parkinson's Disease

目的:评价立体定向丘脑腹外侧核毁损术的疗效及适应证选择。方法:对42例原发性帕金森病应用MRI行丘脑腹外侧核定位,以微电极进行功能定位后,应用射频毁损治疗。手术前后进行UPDRS计分并计算改善率。结果:42例均有显著近期疗效,术后2例出现轻微并发症。症状改善率:开状态(71.1±8.2)％,关状态(86.1±9.2)％(P<0.001)。平均随访34.8个月,7例于6～12个月后行对侧手术,疗效均稳定。结论:立体定向丘脑腹外侧核毁损术治疗帕金森病有显著疗效,严格掌握适应证的选择,应用微电极技术进行功能定位,适当的毁损容积是手术成功的保障。

Objective:To assess the effect of stereotactic thalamotomy on Parkinson's disease (PD)and its 'indications. Methods: From 1996 to 2000, the targets of 42 patients with primary PD were identified with MRI prior to thalamotomy and re-affirmed by microelectrode recording during surgery. Using UPDRS, clinical evaluations were carried out pre-and postoperatively.Results:All the symptoms of PD were significantly improved after thalamotomy.The rate of improvement was(71.1+8.2)% (on periods) or(86.1+ 9. 2)% (off periods) . Light complications occurred only in 2 patients.Conclusion: The effect of stereotactic thalamotomy on PD is significant and the criterions for indication-choice play an important role in the efficacy of surgical treatment.