脑深部电刺激手术治疗帕金森型多系统萎缩临床疗效的研究  

Clinical Efficacy of Deep Brain Stimulation Surgery for Parkinson’s Multi-System Atrophy

作　　者：杨海燕 李忠华 黄礼德[2] 

机构地区：[1]右江民族医学院研究生院,广西 百色 [2]百色市人民医院神经外科,广西 百色

出　　处：《临床医学进展》2023年第8期13162-13170,共9页Advances in Clinical Medicine

摘　　要：目的:拟探讨脑深部电刺激手术治疗帕金森型多系统萎缩的临床疗效。方法:选取百色市人民医院2021年1月至2022年3月收治的29例帕金森型多系统萎缩患者,按照随机分组的方法分为手术组(9例)和对照组(20例),手术组采用丘脑底核脑深部电刺激手术治疗,对照组采用药物保守治疗,比较2组术后1个月、3个月、6个月和1年的① 统一帕金森病评定量表(UPDRS)、② 日常生活能力量表(ADL)、③ 非运动症状筛查量表(NMSS)、④ 汉密尔顿抑郁量表(HAMD)、⑤ 汉密尔顿焦虑量表(MHMD)、⑥ 改良淡漠评定量表(MMSE)的评分。结果:两组患者术前的一般资料差异无统计学意义(P > 0.05),而手术组术后1个月、3个月、6个月、1年的改良淡漠评定量表较对照组变化不大(P > 0.05),差异无统计学意义。ADL评分明显高于对照组(P < 0.05),其他各项评分均明显低于对照组(P < 0.05),差异有统计学意义。结论:脑深部电刺激手术治疗帕金森型多系统萎缩有一定的临床疗效,患者术后运动、非运动症状评分及精神行为认知均明显提高,因此是安全、有效的治疗方法,值得推广。Objective: To investigate the clinical effect of deep brain stimulation in the treatment of Parkinson’s multi-system atrophy. Methods: Twenty-nine patients with Parkinson’s multiple system atrophy admitted to Baise People’s Hospital from January 2021 to March 2022 were selected and divided into an operation group (9 cases) and a control group (20 cases) according to random grouping. The operation group was treated with deep brain stimulation of subthalamus nucleus, while the control group was treated with conservative drug therapy. The results of ① Unified Parkinson’s Disease Rating Scale (UPDRS), ② Ability of Daily Living (ADL), ③ non-motor Symptom Screening Scale (NMSS), ④ Hamilton Depression Scale (HAMD), ⑤ Hamilton Anxiety Scale (MHMD), and ⑥ Modified Inactivity Rating Scale (MMSE) were compared 1 month, 3 months, 6 months and 1 year after sur-gery. Results: There was no significant difference in the general data of the two groups before sur-gery (P > 0.05), while the modified indifference rating scale of the operation group at 1 month, 3 months, 6 months and 1 year after surgery had no significant difference compared with the control group (P > 0.05). ADL score was significantly higher than control group (P < 0.05), and other scores were significantly lower than control group (P < 0.05), the difference was statistically significant. Conclusion: Deep brain stimulation has a certain clinical effect in the treatment of Parkinson’s mul-ti-system atrophy, and the scores of motor and non-motor symptoms and mental behavior cognition of patients after surgery are significantly improved. Therefore, it is a safe and effective treatment method, worthy of promotion.

关 键 词：帕金森型多系统萎缩 脑深部电刺激 临床疗效 非运动症状 

分 类 号：R74[医药卫生—神经病学与精神病学]