摘要
目的 总结帕金森病 (PD)苍白球和丘脑毁损术的术式的选择与疗效关系。方法 对 2 13例PD进行了微电极导向立体定向手术治疗 ,其中苍白球腹后部毁损术 (PVP) 171例 ;丘脑腹中间核 (Vim)毁损术 2 1例 ;同期同侧PVP和Vim毁损术 8例 ;同期双侧PVP 5例 ;分期双侧PVP8例。结果 术后UPDRS评分发现上述各种术式在“关”状态下和“开”状态下症状均有明显改善 ,改善率分别为 5 0 .8%～ 6 0 .8%和 2 8.7%～ 36 .6 % ,其中以多靶点毁损术为佳。同期双侧PVP发生明显构音障碍、吞咽困难 1例。结论 根据不同症状选择不同术式 ,同期双侧PVP术后易产生并发症 。
Objective The goal of this study was to investigate the impact of different microelectrode guided ablative procedures on patients with Parkinson's disease and their effects. Methods Two hundred and thirteen patients with Parkinson's disease underwent different diablative procedures.There was unilateral pallidotomy on 171 patients, unilateral thalamotomy in 21 patients,simultaneous unilateral pallidotomy and thalamotomy in 8 patients, simultaneous bilateral pallidotomy in 5 patients and staged bilateral pallidotomy in 8 patients, Results Significant improvements in all different ablative procedures were observed both in the “off ”period scores(from 50.8%to 60.8%)and in the “on ”period scores(from 28.7%to36.6% ) for the Unified Parkinson's Disease Rating Scale . Multi targets ablative procedures were more effective than single target ablative procedures. One patient who receiving simultaneous bilateral pallidotomy had severe dysphagia and dysarthria.Conclusion These results indicate that different ablative procedures should be taken according to their clinical manifestations, but simultaneous bilateral pallidotomy conferred a higher risk of corticobulbal syndrome.
出处
《上海医学》
CAS
CSCD
北大核心
2002年第2期69-72,共4页
Shanghai Medical Journal
