帕金森病外科定位手术的解剖学基础及其临床应用  

Anatomic Foundation and Clinic Application of Stereotactic Surgery for Parkinson′s Disease

作　　者：沃雁[1] 夏蓉[1] 丁文龙[1] 

机构地区：[1]上海交通大学医学院解剖教研室,上海200025

出　　处：《解剖科学进展》2006年第3期279-283,共5页Progress of Anatomical Sciences

基　　金：上海市教委第四期重点学科资助项目(2005JY03)

摘　　要：帕金森病在老龄化社会的发病率很高,是常见的神经系统退行性疾病之一。毁损过度兴奋的内侧苍白球和底丘脑是外科定位手术治疗帕金森病的解剖学基础,单侧苍白球毁损术对控制进展性的帕金森病及药物治疗无效的患者有作用,术后生活质量有明显的改善。尽管底丘脑核团深部刺激术的解剖学基础仍需进一步研究并存有争议,但Krack等采用“联合PD分级标准”(UPDRS)临床评价量表对49例行底丘脑深部刺激术患者术后5年的长期观察发现,术后运动总评分提高54%(P<0.001)。通过单侧苍白球毁损术及底丘脑深部刺激术治疗帕金森病具有较好的临床效果。Parkinson＇s disease （PD） is a common neurodegenerative disease which has high incident rate in an advanced age society. Ablation surgery of unilateral pallidotomy （UP） and deep brain stimulation of the subthalamic nucleus （STN-DBS） damaging overexcitaed glohus pallidus internum （Gpi） and subthalamic nucleus （STN） is the anatomic foundation of stereotactic surgery treatments of PD. Unilateral pallidotomy is now considered useful to manage patients with PD and motor complications who have not adequately responded to pharmacological management. Furthermore, the results clearly indicate that patients undergoing UP were recorded statistically significant improvements of the quality of life. Although the anatomic foundation about STN-DBS needs continuous research and remains very controversial, 49 patients treated with STN-DBS were improved by 54 percent （ P 〈 0. 001 ） in motor function according to the Krack＇s study using Unified Parkinson＇s Disease Rating Scale （UPDRS）. The benefits of UP and STN - DBS in patients with PD have been well documented in clinical therapy.

关 键 词：解剖学基础 帕金森病 外科定位 其临床应用 定位手术 神经系统退行性疾病 苍白球毁损术 术后生活质量 

分 类 号：R742.5[医药卫生—神经病学与精神病学]