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目的探讨双侧丘脑底核(STN)脑深部刺激术(DBS)治疗帕金森病的临床经验。方法从2002年到2005年共完成了13例帕金森病的双侧丘脑底核DBS,根据STN解剖学定位,靶点的理论坐标值是X=11~13mm,Y=0~-2mm,Z=0~4mm,通过立体定向技术在双侧丘脑底核植入刺激电极,并于锁骨下方植入脑深部电刺激器。结果随访时间为6个月到3年,3例震颤为主病人的症状完全缓解,即震颤完全消失;僵直和运动迟缓为主要症状者的症状缓解程度达90%以上,其中以四肢肌肉僵直的效果较好,运动迟缓也有明显缓解,但是有1例病人双侧肢运动协调性差。所有患者植物神经功能症状有较明显改善,如便秘、流涎、出汗和浮肿等均有改善。结论DBS治疗帕金森病,是帕金森病治疗的一个里程碑似的进步。它可以明显地缓解帕金森病的主要症状和体征,对运动迟缓、僵直和震颤等均有较理想的效果。
Objective To investigate the clinical experience of bilateral deep subthalamic nucleus (STN) brain stimulation (DBS) in the treatment of Parkinson’s disease. Methods Thirteen cases of bilateral subthalamic nucleus of Parkinson’s disease (DBS) were completed from 2002 to 2005. According to the anatomical location of STN, the theoretical coordinates of target were X = 11 ~ 13mm, Y = 0 ~ -2mm, Z = 0 ~ 4mm. The stimulation electrodes were implanted into the bilateral subthalamic nuclei by stereotactic technique and implanted deep into the subclavian electric stimulator. Results The follow-up time ranged from 6 months to 3 years. The symptoms of 3 patients with tremor were completely relieved, that is, the tremor completely disappeared. The degree of remission was more than 90% with stiffness and movement retardation as the main symptoms. Among them, The effect is good, slow motion also significantly alleviated, but there is a case of patients with poor bilateral motor coordination. All patients with autonomic dysfunction have more significant improvements, such as constipation, salivation, sweating and edema were improved. Conclusions DBS for Parkinson’s disease is a landmark improvement in the treatment of Parkinson’s disease. It can significantly alleviate the main symptoms and signs of Parkinson’s disease, the slow, stiff and tremor, etc. have a more satisfactory results.