脑深部电刺激术对帕金森病相关性疼痛的短期疗效  

Short-term effect of deep brain stimulation on pain associated with Parkinson′s disease

作　　者：徐梦婷 陶英群 金海 巩顺 杨兴旺 孙霄 刘阳 王诗邈 宋伟龙 Xu Mengting;Tao Yingqun;Jin Hai;Gong Shun;Yang Xingwang;Sun Xiao y Liu Yang;Wang Shimiao;Song Weilong(Department of Neurosurgery,Northern Theater Command General Hospital,Shenyang 110016,China)

机构地区：[1]北部战区总医院神经外科,沈阳110016

出　　处：《中华神经外科杂志》2019年第12期1216-1220,共5页Chinese Journal of Neurosurgery

基　　金：国家自然科学基金(81870890);国家科技支撑计划(2016YFC0105904SJT)。

摘　　要：目的探讨脑深部电刺激术(DBS)治疗帕金森病相关性疼痛的短期疗效。方法回顾性分析2017年1月至2018年6月北部战区总医院神经外科收治的47例存在疼痛症状帕金森病患者的临床资料。35例患者采用以丘脑底核(STN)为靶点的DBS(STN-DBS组),12例患者行以苍白球内侧部(GPi)为靶点的DBS(GPi-DBS组)。术后3周开机进行刺激触点的选择和参数调整。采用视觉模拟评分法(VAS)评价术前、术后的疼痛程度。结果47例患者术后开机3、6个月的中位VAS评分(范围)分别为1.0(0.5~1.4)分和1.0(0.7~1.6)分,与术前中位VAS评分[4.0(4.0~8.0)分]比较,差异均有统计学意义(均P<0.001)。术后开机3个月,STN-DBS组和GPi-DBS组患者的VAS评分改善率分别为(79.5±26.3)%和(76.9±28.4)%,术后开机6个月分别为(75.1±27.4)%和(82.8±28.9)%,两组的差异均无统计学意义(均P>0.05)。结论DBS能够有效缓解PD相关性疼痛,且GPi-DBS和STN-DBS对其疗效相似。Objective To investigate the short-term outcome of deep brain stimulation(DBS)for the treatment of pain associated with PD(Parkinson′s disease).Methods The clinical data of 47 cases of PD patients with pain symptoms admitted to Neurosurgery Department of Northern Theater Command General Hospital from January 2017 to June 2018 were retrospectively analyzed.A total of 35 patients underwent STN(subthalamic nucleus)-DBS and 12 patients underwent GPi(globus pallidus internus)-DBS.The stimulation contact selection and parameter adjustment were carried out at 3 weeks post operation.Visual analogue scale(VAS)was used to evaluate the degree of preoperative and postoperative pain severity.Results The VAS[median(upper and lower quartiles)]were 1.0(0.5-1.4)and 1.0(0.7-1.6)respectively at 3 months and 6 months post operation in 47 patients,which was statistically different from that of pre-operation 4.0(4.0-8.0)(both P<0.001).At 3 months post operation,the improvement rate of 35 patients undergoing STN-DBS was(79.5±26.3)%,which was not statistically different from that of 12 patients undergoing GPi-DBS[(76.9±28.4)%](P=0.78).The improvement rate of 35 patients receiving STN-DBS was(75.1±27.4)%6 months after operation,which was not statistically different from that of 12 patients receiving GPi-DBS[(82.8±28.9)%](P=0.86).Conclusion Deep brain stimulation could effectively relieve PD-related pain.There seems no significant difference between GPi-DBS and STN-DBS in the treatment outcome of PD-related pain.

关 键 词：帕金森病 疼痛 深部脑刺激法 治疗结果 

分 类 号：R74[医药卫生—神经病学与精神病学]