双侧苍白球腹后部毁损术治疗帕金森病5年随访研究  

A five year follow-up study of bilateral posteroventral pallidotomy for Parkinson disease

作　　者：邵明[1] 

机构地区：[1]广州医学院第一附属医院神经内科,510120

出　　处：《中国微侵袭神经外科杂志》2011年第2期63-65,共3页Chinese Journal of Minimally Invasive Neurosurgery

摘　　要：目的评价双侧苍白球腹后部毁损术(PVP)治疗帕金森病的长期疗效与并发症。方法回顾性分析13例接受双侧PVP的帕金森病病人的临床资料,采用统一帕金森病评定量表(UPDRS),在术前、术后1周和5年,对每例帕金森病病人分别进行"开"、"关"两种状态的评分,并进行统计学分析。结果 13例病人术前"开"状态下UPDRS总分为(44.9±19.5)分,术后1周为(28.6±24.4)分显著低于术前(P<0.05),术后5年为(78.9±32.3)分显著高于术前(P<0.01);"关"状态下术前UPDRS总分为(95.5±23.4)分,术后1周为(41.6±25.6)分显著低于术前(P<0.01),术后5年为(96.6±28.2)分与术前无差别。震颤评分在"开"状态下术后1周显著低于术前(P<0.05),而术后5年与术前无明显差别;在"关"状态下术后1周和5年分值均显著低于术前(均P<0.01)。语言、吞咽和平衡功能的评分术前在"开"状态时基本正常,术后5年的评分显著高于术前(P<0.05,P<0.05,P<0.01)。结论双侧PVP治疗帕金森病的长期疗效不理想,术后5年基本保持对震颤的改善,但其他症状较术前恶化,尤其是语言、吞咽和平衡功能明显恶化。Objective To evaluate the 5 year follow-up outcome of bilateral posteroventral pallidotomy（PVP） for Parkinson disease.Methods The clinical data of 13 patients who underwent bilateral PVP were analyzed retrospectively.The unified Parkinson disease rating scale（UPDRS） was used to estimate the ＇switch-on＇ and ＇switch-off＇ states of each patients before,one week and 5 years after the operation.The results were analyzed statistically.Results The total UPDRS scores at ＇switch-on＇ state before,one week and 5 years after PVP were 44.9±19.5,28.6±24.4 and 78.9±32.3 respectively.The preoperative score was higher than one week after operation（P0.05） and lower than 5 years after operation（P0.01）.The UPDRS scores at ＇switch-off＇ state before,one week and 5 years after PVP were 95.5±23.4,41.6±25.6 and 96.6±28.2 respectively.The preoperative score was higher than one week after operation（P0.01） but showed no significant difference from the score 5 years after the operation.The preoperative score of tremor at ＇switch-on＇ state was higher than one week after the operation（P0.05）,but had no significant difference from the score 5 years after the operation.However,the preoperative score of tremor at ＇switch-off＇ state was higher than both one week and 5 years after operation（both P0.01）.The scores of speech,swallow and balance functions were normal at ＇switch-on＇ state preoperatively,but preoperative scores of three functions were lower than those at 5th year after operation（P0.05,P0.05,P0.01 respectively）.Conclusions The long-term outcome of bilateral PVP for Parkinson disease is not ideal except that the improvement of tremor can maintain for 5 years postoperatively.Other symptoms could deteriorate after operation,especially in speech,swallow and balance functions.

关 键 词：帕金森病 苍白球腹后部毁损术 双侧 

分 类 号：R742.5[医药卫生—神经病学与精神病学]