帕金森病患者双侧丘脑底核脑深部电刺激术后2年非运动症状的研究  

A two-year survey on non-motor symptoms after bilateral subthalamic nucleus deep brain stimulation in patients with Parkinson's disease

作　　者：王珏[1,2,3] 邱娴 高颖[2] 寿文华 徐露 李殿友[3] 王林斌[3] 孙伯民 朱大乔[2] Wang Jue;Qiu Xian;Gao Ying(Department of Nursing,Ruijin Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200025,China;School of Nursing,Shanghai Jiao Tong University,Shanghai 200025,China;Department of Neurosurgery,Ruijin Hospital,School of Medicine,Shanghai Jiao Tong University,Center of Functional Neurosurgery,Ruijin Hospital,School of Medicine,Shanghai Jiao Tong University,Shanghai 200025,China)

机构地区：[1]上海交通大学医学院附属瑞金医院护理部,上海200025 [2]上海交通大学护理学院 [3]上海交通大学医学院附属瑞金医院神经外科,上海交通大学医学院附属瑞金医院功能神经外科中心

出　　处：《立体定向和功能性神经外科杂志》2023年第4期193-199,共7页Chinese Journal of Stereotactic and Functional Neurosurgery

基　　金：2022上海交通大学医学院附属瑞金医院护理科研基金项目(编号:RJHK-2022-6);2022年度上海交通大学医学院护理科研面上项目(编号:Jyh2203);上海高水平地方高校创新团队建设项目(编号:SHSMU-ZDCX20212801);上海交通大学医学院护理学科人才建设项目(编号:SJTUHLXK2021);上海申康医院发展中心临床科技创新项目(编号:SHDC-12021625)。

摘　　要：目的了解帕金森病患者行双侧丘脑底核脑深部电刺激术(STN-DBS)后非运动症状及生活质量的变化情况。方法采取便利抽样法,对上海交通大学医学院附属瑞金医院功能神经外科中心2020年6月1日至2020年8月31日符合双侧STN-DBS疗法适应证的帕金森病患者45人进行问卷调查,运用患者一般资料调查表、非运动症状量表(NMSS)及8项帕金森病调查表(PDQ-8)对患者术前及术后3个月、6个月、12个月及24个月时非运动症状及生活质量的情况进行评估与分析。结果经广义估计方程分析发现,患者术后PDQ-8、左旋多巴每日等效剂量(LEDD)的5次随访的整体变化是具有统计学意义的(P<0.05),NMSS中,心血管维度和感知障碍维度的整体变化没有统计学意义(P>0.05),而睡眠/疲劳、情绪/冷漠、注意力/记忆、胃肠道症状、泌尿系统症状、性功能及混合症状的整体变化均具有统计学意义(P<0.05)。结论双侧STN-DBS术可长期改善帕金森病患者的睡眠/疲劳及泌尿系统症状;在短期内改善情绪/冷漠、注意力/记忆及性功能;对胃肠道症状及混合症状均具有一定的改善作用;同时可减少患者药物治疗的剂量,提高患者的生活质量。Objective To investigate the changes of non-motor symptoms and quality of life in patients with Parkinson's disease(PD) after bilateral subthalamic nucleus deep brain stimulation(STN-DBS).Methods Questionnaires were conducted among a convenience sample of 45 PD patients who met the indications of STN-DBS in the Functional Neurosurgery Center of Ruijin Hospital, Shanghai JiaoTong University School of Medicine in Shanghai from June 1,2020 to August 31,2020.The Non-motor Symptom Scale(NMSS) and 8-item Parkinson's Disease Questionnaire(PDQ-8) were used to evaluate the patients' non-motor symptoms and quality of life preoperatively and at 3,6,12 and 24-month postoperative visits.Results Generalized estimation equation analysis showed a significant overall change of PDQ-8 and levodopa equivalent daily dose(LEDD) over five follow-up visits(P<0.05).Sleep/fatigue, Mood/apathy, Attention/memory, Gastrointestinal, Urinary, Sexual function and Miscellaneous subscores showed a statistically significant decreasing trend(P<0.05),while Cardiovascular and Perceptual subscores of NMSS were unchanged(P>0.05).Conclusion Bilateral STN-DBS has a long-term benefit on sleep/fatigue and urinary symptoms and a short-term benefit on Sleep/fatigue, Mood/apathy, Attention/memory, Gastrointestinal, Urinary, Sexual function and Miscellaneous symptoms in PD patients.Moreover, it can reduce the medication intake and improve the patients' quality of life.

关 键 词：帕金森病 脑深部电刺激 非运动症状 生活质量 纵向研究 

分 类 号：R742.5[医药卫生—神经病学与精神病学]