丘脑底核脑深部电刺激对帕金森病术后药物治疗的影响(附40例分析)  

Effects of deep brain stimulation of the subthalamic nucleus on the postoperative antiparkinsonian medication

作　　者：马羽[1] 张建国[2] 冯涛[3] 

机构地区：[1]中国医科大学附属第一医院神经外科,辽宁沈阳110001 [2]首都医科大学附属北京天坛医院神经外科神经内科,北京100050 [3]首都医科大学附属北京天坛医院神经内科,北京100050

出　　处：《中国微侵袭神经外科杂志》2006年第3期102-104,共3页Chinese Journal of Minimally Invasive Neurosurgery

摘　　要：目的观察帕金森病(PD)病人丘脑底核脑深部电刺激(STN-DBS)术后药物变化情况,探讨STN-DBS对帕金森病术后药物治疗的影响。方法对接受STN-DBS手术治疗的40例帕金森病病人手术前后的药物服用剂量、药物引起的相关并发症等情况进行回顾性分析。结果本组经6￣49个月随访,多数病人在STN-DBS作用下因症状明显改善,于开机后的1～6个月间使用抗PD药物逐渐减量,最终的选择剂量可维持2年以上。开机后5例不再服用相关药物,25例药物较术前平均减少60%,7例药物用量与术前相同,3例行单侧STN-DBS者术后药物用量增加。药物相关并发症因术后药物用量的减少而得到明显缓解。结论STN-DBS能够减少术后抗PD药物的用量,改善药物引起的相关并发症。Objective To observe the changes in antiparkinsonian medication of Parkinson disease （PD） patients after deep brain stimulation （DBS） of the subthalamic nucleus （STN） and to detcnrmine effect of STN-DBS on antiparkinsonian medication. Methods The pre- and post-operative conditions of antiparkinsonian medication and complications induced by levodopa were retrospectively analyzed in PD patients who underwent STN-DBS. Results The patients were followed up for 6-49 months. The antiparkinsonian medication was reduced gradually in most of the PD patients during 1-6 months after STN-DBS. And the final dosage could bc kept for at least 2 years. In the 40 patients, 25 experienced average 60% reduction in antiparkinsonian medication, 7 still had the same dosage as preoperatively and 5 did not need medication any more. Three patients undergoing one-side STN-DBS needed an increased dosage. The complications induced by levodopa were remarkably improved with the reduction of antiparkinsonian medication. Conclusion STN-DBS could replace levodopa and reduce the losage of antiparkiusonian medication postoperatively, which result in the remarkable improvement of complications.

关 键 词：帕金森病 丘脑底核 深部脑刺激法 左旋多巴 

分 类 号：R651[医药卫生—外科学]