微电极引导立体定向下丘脑腹中间核毁损术治疗特发性震颤  

Microelectrode-guided stereotactic thalamotomy (Vim nucleus-damaged procedure) for essential tremor

作　　者：郭效东 高国栋[2] 王本瀚 王庆宣 熊家锐 张长远 张月高 刘明辉 

机构地区：[1]153医院神经外科,河南郑州450042 [2]第四军医大学唐都医院神经外科,陕西西安710038

出　　处：《实用医药杂志》2006年第4期390-392,共3页Practical Journal of Medicine & Pharmacy

摘　　要：目的探讨微电极引导立体定向下丘脑腹中间核(Vim核)毁损术治疗特发性震颤(ET)的临床疗效和并发症。方法对55例ET患者采用微电极导向技术确定Vim核的位置,进行单侧丘脑毁损术。对患者术前术后肢体震颤、生活功能改善情况及并发症进行定性评估和分析。结果手术对侧肢体震颤完全消失47例,在精神紧张时仍遗留有轻微震颤8例,头颈、躯干部震颤及声音震颤亦有所改善,同侧肢体震颤无缓解。术后复发3例,同侧二次手术后震颤完全控制。长期随访疗效稳定,患者生活质量明显提高。一过性并发症15例,均在1～3周后消失,无永久性并发症。结论微电极引导立体定向下单侧Vim核毁损术治疗ET是一种安全、高效、微创的方法,准确定位是手术成功的保障。Objective To explore the effects and complications of microelectrode-guided stereotactic thalaraotomy for essential tremor （ET）. Methods Total 55 ET patients received microelectrode-guided technique to locate their Vim nucleus, then were subjected to unilateral thalamotomy.The tremor of limb and improvement of the quality of life before and after operation were qualitatively evaluated.Results 47 patients＇s opposite limb tremor disappeared completely;8 patients remain slight limb tremor when they were nervous,their tremor of head,neck,trunk and voice had slightly improved.Homolateral limb＇s symptoms hadn＇t relieved; 3 patients accepted a second operation after setback,then their tremor had controlled completely,and long-term effects were stable and their life quality distinctly increased;15 cases got a transient complications, but all complications disappeared in short time （1-3 weeks）,no permanent complications occurred.Conclusion Microelectrode-guided stereo-tactic unilateral thalamotomy （Vim nucleus-damaged procedure） is safe, effective and minimally invasive way for ET; It is key to locate accurately Vim nucleus.

关 键 词：特发性震颤 立体定向 丘脑毁损术 微电极导向 

分 类 号：R742.5[医药卫生—神经病学与精神病学]