丘脑底核电刺激治疗原发性肌张力障碍长期随访研究  

Long-term follow-up study of subthalamic nucleus stimulation for primary dystonia

作　　者：降建新[1] 潘宜新[2] 王小林[1] 曹春燕[2] 李殿友[2] 占世坤[2] 潘斯俭 张璟[2] 孙伯民[2] 鲁峻[1] 

机构地区：[1]泰州市人民医院神经外科,225300 [2]上海交通大学附属瑞金医院功能神经外科,200025

出　　处：《中国微侵袭神经外科杂志》2017年第12期533-536,共4页Chinese Journal of Minimally Invasive Neurosurgery

基　　金：江苏大学临床科技发展基金项目(编号:JLY20160147)

摘　　要：目的探讨丘脑底核-脑深部电刺激术(STN-DBS)治疗原发性肌张力障碍的长期疗效。方法回顾性分析34例接受双侧STN-DBS治疗的原发性肌张力障碍病人的临床资料,在术前及术后1、12、24个月采用Burke-Fahn-Marsden肌张力障碍评估量表(BFMDRS)和健康调查简表SF-36评估治疗效果。随访2~10年,平均(5.5±2.5)年;其中19例随访超过5年。结果本组病人术后症状均明显改善,长期疗效稳定,在术后1、12、24个月,BFMDRS运动量表评分和SF-36评分均在术后1个月明显提高(P<0.05),并术后12个月进一步提高(P<0.05),12个月后保持稳定。副作用主要包括电极移位、电极断裂、移植排斥反应和持续抑郁症状。结论 STN-DBS植入术治疗原发性肌张力障碍治疗效果显著,能明显改善运动症状,提高生活质量,长期疗效稳定,且使用寿命更长。Objective To investigate long-term efficacy of subthalamic nucleus deep brain stimulation（STN-DBS） for the treatment of primary dystonia.Methods Clinical data of 34 patients with primary dystonia receiving bilateral STN-DBS treatment were analyzed retrospectively.All the patients were evaluated with Burke-Fahn-Marsden dystonia rating scale（BFMDRS） and 36-item short form（SF-36） of health survey before surgery and 1,12,24 months after surgery.The mean follow-up time was 5.5±2.5 years,ranged from 2 to10 years,and 19 patients were followed up more than 5 years.Results All the patients experienced a remarkable long-term and stable improvement after stimulation.The motor scale of BFMDRS and SF-36 scores significantly improved 1 month after stimulation（P 〈0.05）,further improved 12 months after simulation（P 〈0.05）,and kept stable after 12 months.The adverse events included misplacement or breakage of the electrode,implant rejection and sustained depression.Conclusions STN-DBS implantation is significantly effective for primary dystonia,can significantly improve the motor symptoms and quality of life,and maintain stable long-term efficacy and longer working life.

关 键 词：原发性肌张力障碍 丘脑底核 脑深部电刺激 

分 类 号：R746[医药卫生—神经病学与精神病学]