脑深部刺激治疗运动障碍性疾病的并发症和不良反应分析(附67例报道)  

Complications and side effects of deep brain stimulation therapy for movement disorders in 67 cases

作　　者：胡小吾[1] 周晓平[1] 姜秀峰[1] 王来兴[1] 郝斌[1] 曹依群[1] 金爱国[2] 曾浩[2] 

机构地区：[1]第二军医大学附属长海医院神经外科,上海200433 [2]第二军医大学附属长海医院放射科,上海200433

出　　处：《上海医学》2006年第6期353-355,共3页Shanghai Medical Journal

摘　　要：目的总结脑深部刺激(DBS)治疗运动障碍性疾病的并发症和不良反应。方法自2000年1月至2004年3月采用DBS治疗67例(101侧)患者,其中帕金森病63例,特发性震颤2例及扭转痉挛、舞蹈病各1例。手术采用磁共振扫描结合微电极记录技术进行靶点定位。术后随访3个月～4年,平均7．3个月,进行临床疗效评价。结果DBS后的并发症和不良反应有电极放置不准确需要重新调整2例,刺激电极与皮下导线连接处头皮切口破溃1例,胸部脉冲发生器植入处皮下感染1例,记忆力轻度减退2例,情绪改变7例,肢体异动20例,睁眼困难1例；均未发生明显的致残性永久并发症和不良反应。结论DBS是一种较为安全的微创外科治疗手段,提高术者的手术熟练程度可降低其并发症和不良反应的发生率。Objective Deep brain stimulation（DBS） for alleviation of movement disorders is now well established. However, the complications and adverse effects associated with the procedure was not well known. The aim of this study is to review and evaluate the adverse events of DBS procedure. Methods Sixty-seven patients including 63 medically intractable Parkinson＇s disease（PD）, two with essential tremor, one with torsion spasm, and one with chorea underwent simultaneous bilateral 34 DBS procedures and unilateral 33 DBS procedures between January 2000 and March 2004. The target was identified by a combination of MRI neuroimaging and microelectrode recording. The mean follow-up duration was 7. 3 months（range 3～48 months）. Results Complications and adverse effects occurred including stimulator repositioning in 2 cases, scalp erosion in one, infraclavicular cutaneous infection in one, mild memory decline in 2, mood changes in 7, dyskinesias in 20 and eyelid opening apraxia in one, but there were no serious adverse events or permanent morbidity. Conclusion Bilateral or unilateral DBS is a safe invasive procedure and the complication rate depends on the experience and skill of the performes.

关 键 词：脑深部刺激 运动障碍性疾病 并发症 不良反应 

分 类 号：R741[医药卫生—神经病学与精神病学]