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目的探讨双核丘脑底核脑深部电刺激(STN-DBS)对帕金森病异动症的缓解作用。方法将2013年1月至2016年3月治疗的帕金森病异动症患者90例按随机数字表法分为三组,每组30例,3组均给予左旋多巴治疗,A组仅给予左旋多巴治疗,B组加予功能核团毁损术(FNLO)治疗,C组加予STN-DBS治疗,术前、术后1个月、6个月评价异动症缓解情况,并记录左旋多巴使用剂量。结果 B组、C组术后1个月、6个月“开”、“关”期统一帕金森病评定量表Ⅲ(UPDRSⅢ)评分、伯克法恩-马斯登肌张力障碍量表(BFMDRS)评分均低于治疗前及A组,但B组、C组比较差异无统计学意义(P>0.05);A组治疗6个月后左旋多巴用量不降反升(P<0.05);B组、C组术后1个月、6个月左旋多巴用量均少于术前(P<0.05),但2组术后1个月、6个月左旋多巴用量比较差异无统计学意义(P>0.05);B组并发症发生率高于A组、C组(P<0.05)。结论 STN-DBS对异动症的改善作用与FNLO相当,两种术式也都能显著减少左旋多巴用量,但STN-DBS术后并发症少,安全性更高。
Objective To investigate the alleviating effect of STN-DBS on Parkinson’s disease (AD). Methods From January 2013 to March 2016, 90 patients with Parkinson’s disease were divided into three groups according to the random number table method, 30 cases in each group, 3 groups were treated with levodopa, group A was given only levorotatory Dopa treatment, group B was treated with functional nucleus degeneration (FNLO), group C was treated with STN-DBS. The patients were treated with preoperative, 1 month and 6 months postoperatively, and the levodopa Use dose. Results In group B and group C, the UPDRS Ⅲ score at 1 month, 6 months after operation, “ON” and “OFF” period in group C, (BFMDRS) scores were lower than those before treatment and in group A, but there was no significant difference between group B and group C (P> 0.05); The dosage of levodopa in group A after 6 months of treatment did not decrease or rise (P <0.05). The dosage of levodopa at 1 month and 6 months after operation in group B and group C were all less than those before operation (P <0.05), but the dosage of levodopa in group 1 and 6 The difference was not statistically significant (P> 0.05). The incidence of complications in group B was higher than that in group A and group C (P <0.05). Conclusions STN-DBS can improve the dyskinesia and FNLO equally. Both of the two procedures can significantly reduce the dosage of levodopa. However, STN-DBS has fewer complications and higher safety.