脑深部电刺激治疗帕金森病的临床应用  

Beep brain stimulation in treatment of Parkinson's disease:a consecutive seriies of 30 patients

作　　者：周晓平[1] 胡小吾[1] 王来兴[1] 姜秀峰[1] 曹依群[1] 金爱国[1] 倪宝英[1] 

机构地区：[1]第二军医大学长海医院神经外科,上海200433

出　　处：《立体定向和功能性神经外科杂志》2003年第4期187-190,共4页Chinese Journal of Stereotactic and Functional Neurosurgery

摘　　要：目的　探讨脑深部电刺激术 (DBS)治疗帕金森病 (PD)的手术方法和脉冲发生器程控调节。方法　脑深部电刺激术治疗帕金森病 36例 ,其中丘脑底核 (STN) 35例和丘脑腹中间核 (Vim) 1例 ,单侧 1 8例 ,双侧 1 8例。采用磁共振扫描结合微电极记录技术进行靶点定位。术后用UPDRS运动评分评价刺激效果。结果　 36例PD患者术后随访 2～ 32个月 ,平均 6 .3个月。脉冲发生器开启时 ,在“关”状态下 ,UPDRS运动评分改善率 4 5 .2 % ;在“开”状态下 ,UPDRS运动评分改善率 2 0 .7% ,未发现任何并发症。结论　DBS能有效控制PD症状 ,手术并发症少 ,术后可调节参数 。Objective The objective of the study presented here was to describe the technical approach and to assess the efficacy and safety of deep brain stimulation of the subthalamic nucleus and ventralis intermedius in Parkinson’s disease(PD).Methods Thirty and six patients with medically intractable PD underwent unilateral subthalamic(17 case) and ventralis intermedius(1 case) and bilateral subthalamic(18 case) stimulation. The target was identified by a combination of MRI neuroimaging and microelectrode recording .We compared scores on the motor portion of the Unified Parkinson's disease rating scale(UPDRS) when the stimulation was turned on or off.Results The mean follow-up duration was 6.3 months(range 2～32 months).Improvement of the UPDRS motor scores was 45.2% when the stimulation was turned on and 20.7% when the stimulation was turned off without any undesirable side effects. Conclusion Our finding showed that subthalamic nucleus stimulation results significant control of the motor symptoms of the patients.

关 键 词：脑深部电刺激 帕金森病 临床应用 手术方法 脉冲发生器 磁共振扫描 微电极记录技术 靶点定位 

分 类 号：R742.5[医药卫生—神经病学与精神病学]