立体定向手术治疗脑深部病变及运动异常(附32例报告)  

Deep-seating cerebral lesions and movement disorders treated by stereotactic operations(report of 32 cases)

作　　者：张捷[1] 陈新军[1] 赵时雨[1] 李志强[1] 曹长军[1] 袁先厚[1] 江普查[1] 谢腾[1] 夏亮[1] 张海泉[1] 吴志敏[1] 罗锐[1] 

机构地区：[1]武汉大学中南医院神经外科,430071

出　　处：《临床外科杂志》2006年第10期651-652,共2页Journal of Clinical Surgery

摘　　要：目的 分析立体定向手术对脑深部病变及运动异常的临床应用价值。方法 采用CT或MRI定位对脑深部囊性病变进行治疗，对诊断不明确的病变进行活检，对帕金森病、痉挛性脑瘫等运动异常进行射频毁损治疗。结果 2例活检的病例均明确了病变性质；随访2～20个月，3例脑深部病变者好转，10例帕金森病患者4例术后震颤、强直消失停用左旋多巴，4例左旋多巴减量至术前1／2～1／3；11例脑瘫及4例特发性震颤患者好转，1例癫痫伴精神症状者无效；无术后昏迷、偏瘫、感染、手术死亡。结论 立体定向手术创伤小、安全性高，对脑深部病变的诊断和治疗以及运动异常的治疗有积极应用价值。Objective To analyze the value of stereotactic operation for the treatment of deep - seating cerebral lesions and movement disorders. Methods With the guide of CT/MRI, deep - seating cerebral lesions were treated by stereotactic asporation or cyst- ventriculo- peritoneal shunt, biopsy and movement disorders were treated by thalamotomy or/and pallidotomy. Results The biopsy cleared the diagnosis. During the 2 - 20 months follow - up period, L - dopa was withdrawn in 4 of the 8 Parkinson disease patients and decreased to 1/2 or 1/3 of pre- operation dosage in other 4 patients. The symptoms were improved in cerebral palsy and essential tremor patients. There was no fatal complication. Conclusion Stereotactic operation is a safe and effective measure for the treatment of deep - seating cerebral lesions and movement disorders.

关 键 词：CT/MRI定位 立体定向手术 痉挛性脑瘫 运动异常 帕金森病 

分 类 号：R651.11[医药卫生—外科学]