双侧丘脑底核脑深部电刺激术治疗帕金森病的疗效分析  

Clinical efficacy of bilateral subthalamic nucleus deep brain stimulation for patients with Parkinson's disease

作　　者：蒋伟 郐国虎[2] 刘魏华 张复弛 舒凯[1] 杨正明[1] 雷霆[1] JIANG Wei;KUAI Guo-hu;LIU Wei-hua;ZHANG Fu-chi;SHU Kai;YANG Zheng-ming;LEI Ting(Department ofNeurosurgery,Tongi Hospital,Tongi Medical College,Huazhong University of Science and'Technology,Wuhan 430030,China;Department of Neurosurgery,Tianyou Hospital Affilicated to Wuhan University of Science and Technology,Wuhan 430064,China)

机构地区：[1]华中科技大学同济医学院附属同济医院神经外科,武汉430030 [2]武汉科技大学附属天佑医院神经外科,武汉430064

出　　处：《中国临床神经外科杂志》2021年第10期755-757,共3页Chinese Journal of Clinical Neurosurgery

摘　　要：目的探讨双侧丘脑底核脑深部电刺激术(STN-DBS)治疗药物难以控制或副反应难以耐受的帕金森病(PD)的疗效。方法回顾性分析2015年6月至2019年6月双侧STN-DBS治疗药物难以控制或副反应难以耐受的171例PD的临床资料。术后6个月采用第三版统一帕金森病评分量表(UPDRS-Ⅲ)评分及第二版世界卫生组织生活质量评定量表(WHO-QOL-2)评分评估疗效。结果术后6个月,UPDRS-Ⅲ评分明显降低(P<0.05),WHO-QOL-2评分明显增高(P<0.05)。术后抗PD药物使用剂量明显降低(P<0.05)。术后发生颅内出血1例(0.58%),切口感染3例(1.75%),排异反应2例(1.17%),癫痫发作1例(0.58%),因设备故障更换脉冲发生器1例(0.58%),体重增加12例(7.01%),构音障碍8例(4.67%),睁眼困难4例(2.34%),智力减退4例(2.34%)。结论对于药物难以控制及副反应难以耐受的PD病人,双侧STN-DBS治疗PD可显著改善病人症状、提高生活质量及减少口服药物量。Objective To investigate the clinical efficacy of bilateral subthalamic nucieus deep brain stimulation(STN-DBS) for the Parkinson’s disease(PD) patients associating with drug-uncontrollable symptoms or severe side effects. Methods The clinical data of 171 patients associating with drug-uncontrollable symptoms or severe side effects who underwent bilateral STN-DBS from June 2015 to June 2019 were analyzed retrospectively. Six months after the operation, Unified Parkinson’s Disease Rating Scale version(3.0)(UPDRS-Ⅲ) and World Health Organization Quality-of-Life Scale version(2.0)(WHO-QOL-2) were used to evaluate the clinical efficacy. Results Six months after the operation, the UPDRS-Ⅲ score was significantly reduced(P<0.05), the WHO-QOL-2 score was significantly increased(P<0.05), and the dosages of anti-PD drugs were significantly reduced(P<0.05). Postoperative intracranial hemorrhage occurred in 1 patient(0.58%), incision infection in 3(1.75%), rejection reaction in 2(1.17%), seizure in 1(0.58%), pulse generator replacement due to equipment failure in 1(0.58%), weight gain in 12(7.01%), dysarthria in 8(4.67%), difficulty in opening eyes in 4(2.34%), and mental retardation in 4(2.34%). Conclusions For PD patients associating with drug-uncontrollable symptoms or severe side effects, bilateral STN-DBS treatment can significantly improve patients’ symptoms, improve patients’ quality of life, and reduce the dosage of anti-PD drugs.

关 键 词：帕金森病 脑深部电刺激 丘脑底核 疗效 

分 类 号：R742.5[医药卫生—神经病学与精神病学] R651.11[医药卫生—临床医学]