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目的观察原发性帕金森病(Parkinson disease,PD)患者行丘脑底核脑深部电刺激术(deep brain stimulation of subthalamic nucleus,STN DBS)的不良事件。方法纳入行STN DBS的原发性帕金森病45例,收集患者一般临床资料,术后随访至3~9年,观察术后不良事件。结果手术相关不良事件:微毁损效应44例、囊袋积液2例、颅内出血1例、嗜睡1例;未观察到任何装置相关不良事件;刺激或疾病相关不良事件:异动症15例、步态平衡障碍12例,焦虑抑郁状态6例,构音障碍与多巴胺失调综合征各4例,智能减退2例,少数患者出现体重增加、幻觉、睁眼困难等。7例患者因共存疾病死亡。结论 STN DBS大部分不良事件可以控制,术后个体化调整参数及药物,有利于减少STN DBS不良事件。
Objective To observe the adverse events of deep brain stimulation of subthalamic nucleus (STN DBS) in patients with primary Parkinson disease (PD). Methods Forty-five patients with primary Parkinson’s disease who underwent STN DBS were enrolled in this study. The general clinical data of patients were collected. The patients were followed up for 3 to 9 years. Postoperative adverse events were observed. Results Surgical-related adverse events included 44 cases of micro-lesion, 2 cases of cystic effusion, 1 case of intracranial hemorrhage and 1 case of drowsiness. No device-related adverse events were observed. Stimulation or disease-related adverse events: 15 cases of dyskinesia 12 cases of state balance disorders, 6 cases of anxiety and depression, 4 cases of dysarthria and dopamine imbalance syndrome, 2 cases of mental retardation, a few cases of weight gain, hallucinations, difficulty in opening eyes. Seven patients died of co-morbidity. Conclusion Most of the adverse events of STN DBS can be controlled. Individualized adjustment parameters and drugs after the operation are helpful to reduce the adverse events of STN DBS.