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目的探讨双侧丘脑底核-脑深部电刺激(STN-DBS)治疗原发性帕金森病(PD)的手术方法及临床疗效。方法采用头颅核磁共振及术中微电极记录电生理技术明确靶点定位,对14例原发性PD患者行STN-DBS手术。随访6个月-8年,评估手术对患者运动症状的改善及术后6个月患者服药剂量减少情况。结果术后6个月患者统一用帕金森评分量表(UPDRS),运动检查评分有明显改善(P<0.05):“开”状态下平均改善率为41.8%,“关”状态下平均改善率为51.6%。患者术后通过调整刺激参数及药物剂量,均能获得满意的生活质量。于术后6个月左右评估,患者服用抗帕金森药物剂量平均减少55.6%(P<0.05)。结论 STN-DBS术治疗原发性PD疗效确切。
Objective To investigate the surgical methods and clinical efficacy of bilateral subthalamic nucleus-deep brain stimulation (STN-DBS) in the treatment of primary Parkinson’s disease (PD). Methods The skull MRI and intraoperative microelectrode recording electrophysiological techniques were used to confirm the location of the target. STN-DBS was performed in 14 patients with primary PD. The follow-up period ranged from 6 months to 8 years. The improvement of the patient’s motion symptom and the reduction of the dose of the medicine after 6 months were evaluated. Results After 6 months, the patients were united with Parkinson’s Rating Scale (UPDRS), and the exercise examination scores were significantly improved (P <0.05). The average improvement rate was 41.8% in the “on” state and “off” state The average improvement rate was 51.6%. Patients after surgery by adjusting the stimulation parameters and drug doses, can get a satisfactory quality of life. At 6 months or so after surgery, patients taking anti-Parkinson drugs decreased on average 55.6% (P <0.05). Conclusion The treatment of primary PD with STN-DBS is effective.