X刀分次治疗帕金森病的临床应用

The clinical research on fractionated irradiation treatment with X knife in patients of PD

目的 探讨帕金森病 (PD)的X刀分次治疗方法 ,为PD找出一条可行的无创治疗途径。方法 16例难治性PD病人 ,采用X刀 14 0Gy分 2次损毁丘脑腹外侧核中间部 (VIM)治疗 ;8例病人采用 16 5Gy分 3次损毁VIM核治疗 ;每次间隔 2 4h。结果 X刀治疗后 3～ 2 4个月随访 ,2 4例病人消除或改善了震颤症状 ;僵直或运动减少症状不同程度的缓解 ;无并发症发生。神经生理学检查无显著改善。结论 X刀分次损毁VIM核 ,可安全、无创治疗PD ;震颤症状改善显著。

Objective To explore X knife treatment methods and to seek a new effective way for PD therapy. Methods Sixteen patients of PD were treated by performing VIM with 2 times of X knife fractionated irradiation (interval, 24 h) to a total dose of 140 Gy, and 8 patients of PD were treated by performing VIM with 3 times of X knife fractionated irradiation (interval, 24 h) to a total of dose of 165 Gy. Results During 3-24 months follow-up after X knife treatment, tremor was stopped in 19 patients and was relived significantly in 5 patients. Rigidity and bradykinesia of PD were relieved slightly. No complications were observed. Conclusion To perform VIM with X knife fractionated irradiation can be safely and effectively used to treat PD. The tremor of PD can be relieved slightly.