同期丘脑和苍白球切开术治疗合并特发性震颤的帕金森病  

Simultaneous thalamotomy and pallidotomy for Parkinsonian patients with essential tremor

作　　者：朱宏伟[1] 李勇杰[1] 

机构地区：[1]首都医科大学宣武医院北京功能神经外科研究所,北京100053

出　　处：《立体定向和功能性神经外科杂志》2001年第1期9-11,共3页Chinese Journal of Stereotactic and Functional Neurosurgery

基　　金：国家科委基金资助项目 !(96 92 0 0 6 0 5 17) ;北京市科委基金资助项目! (95 330 40 0 1)

摘　　要：目的 :研究合并特发性震颤 (Essentialtremor,ET)的帕金森病 (Parkinson’sdisease ,PD)手术治疗的最佳术式 ,评估同期丘脑和苍白球切开术的手术必要性、临床治疗效果、安全性及其适应证 ,探讨可能的治疗机制。方法 :应用微电极导向立体定向技术 ,对 16例合并ET的PD患者实施了同期单侧丘脑和苍白球切开术。采用UPDRS评分法 ,对所有患者进行术前和术后的病情评分 ,分析手术对患者的整体症状 ,特别是震颤症的改善情况及手术并发症的发生情况。结果 :同期单侧丘脑和苍白球切开术能全面改善患者的整体症状 ,手术对侧各种形式的震颤在“开、关”两种状态下均完全消失 ,改善率为 10 0 % ,对震颤的治疗效果优于单纯苍白球切开术。同期丘脑和苍白球切开术与单侧苍白球切开术相比风险相当 ,无严重并发症发生。结论 :同期丘脑和苍白球切开术治疗合并ET的PD患者是一种安全而有效的治疗方案 。Objective:To investigate the optimal surgical strategy for pakinsonian patients with essential tremor(ET).To evaluate outcomes,indications and complications of thalamotomy and pallidotomy combined simultaneously.Methods:UPDRS data from 16 patients (PD with ET) who received microelectrode-guided thalamotomy and pallidotomy simutaniously were analysed retrospectively.Results:simutaniously combined thalamotomy and pallidotomy effectively improved parkinsonian symptoms as well as action tremor.This procedure completely abolished tremor in all of patients at both“on” and “off” states.One patient developed hypokinesia postoperatively and recovered 1 week later.No permanent complications occurred.Conclusions:Simutanious thalamotomy and pallidotomy is a safe and effective procedure in treating PD with ET.It is critical to understand the indications of this combined procedure and apply microrecording technique.

关 键 词：帕金森病 特发性震颤 丘脑切开术 苍白球切开术 治疗 

分 类 号：R742.505[医药卫生—神经病学与精神病学]