运动障碍病脑深部电刺激手术的并发症分析  

Analysis of surgical complications of deep brain stimulation for movement disorders

作　　者：张宇清[1] 李建宇[1] 李继平[1] 王云鹏[1] 刘畅[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,100053

出　　处：《临床神经外科杂志》2016年第1期31-34,共4页Journal of Clinical Neurosurgery

基　　金：国家自然科学基金(81371256)

摘　　要：目的分析运动障碍病脑深部电刺激（DBS）手术的并发症,探讨其原因及预防和治疗措施。方法给615例运动障碍病患者进行了1008根DBS手术,行单侧DBS手术的患者222例,双侧手术者393例。其中帕金森病患者566例,原发性震颤患者18例,肌张力障碍患者11例,痉挛性斜颈患者7例,抽动症患者9例,Meige综合征2例,其他2例。回顾性分析与手术操作或硬件故障相关的并发症。结果 615例患者术后随访1-3年,出现手术操作或硬件相关并发症的患者45例;其中出血4例,植入脉冲发生器（IPG）周围皮下积液10例,感染10例,电极位置不好9例,电极断裂10例,急性水肿1例,IPG不适重新植入1例。结论手术操作中诸多技术环节与术后并发症有关联。手术者经验的提高,可以明显减少手术并发症的发生。Objective To analyze the surgical complications of deep brain stimulation（DBS）for movement disorders（MD） to explore its reason and prevention and treatment measures.Methods615 patients with MD were received 1008 DBS electrodes.Of 615 patients,222 received unilateral DBS surgery and 393 received bilateral DBS surgery.Of 615 patients,566 were medically refractory Parkinson disease,18 essential tremor,11 dystonia,7 cervical distonia,9 tourette,2 Meige syndrome and 2 other hyperkinetic movement disorders.The surgical procedure or hardware failure related complications were analyzed retrospectively.Results 615 patients were followed up for 1-3years.Five severe intraoperative adverse events included intracerebral hemorrhage in 4（0.7%） and acute edema in 1（ 0.2%）.Hardware-related complications requiring surgical revision included wound infections in 10 patients（1.6%）,Subcutaneous effusion around IPG in 10（1.6%）,lead malposition and/or migration in 9（1.5%）,component fracture in 10（1.6%）,hardware discomfort in 1 patient（0.2%）.Conclusions Many operative skills in DBS are associated with postoperative complications.Improving the experience of surgeon can significantly reduce the incidence of surgical complications.

关 键 词：运动障碍病 脑深部电刺激 并发症 

分 类 号：R651.1[医药卫生—外科学]