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目的对帕金森病(PD)患者采用双侧丘脑底核(STN)脑深部电刺激术(DBS)治疗,总结其疗效并进行手术技术改进。方法对50例帕金森病患者采用立体定向方法,磁共振扫描结合微电极记录技术进行靶点定位,双侧丘脑底核植入刺激电极,术中实验性刺激良好后植入刺激器,应用电极锁定装置(stimlock)固定电极,术中复查MRI,常规术后1个月开机,用程控仪遥控调整刺激参数。结果 50例帕金森病患者术后,随访时间3~36个月,平均随访时间12.8个月。开启刺激器时,在“关”状态下,帕金森病统一评分量表(UPDRS)运动评分改善率45.1%,在“开”状态下,UPDRS运动评分改善率25.3%,未发现任何严重并发症。结论 STN DBS手术治疗PD,对症状改善明显,应用电极锁定装置可减少手术并发症。
Objective To study the effect of bilateral deep subthalamic nucleus (STN) deep brain stimulation (DBS) on patients with Parkinson’s disease (PD) and to summarize its curative effect and surgical technique. Methods 50 patients with Parkinson’s disease using stereotactic method, magnetic resonance scanning combined with microelectrode recording technology for target localization, bilateral subthalamic nucleus implantation of stimulation electrodes, intraoperative experimental stimulation is good implanted stimulator, the application of electrodes Locking device (stimlock) fixed electrode, intraoperative review of MRI, 1 month after the start of regular surgery, remote control with program-controlled instrument to adjust the stimulation parameters. Results 50 patients with Parkinson’s disease were followed up for 3 to 36 months with an average follow-up time of 12.8 months. When the stimulator was switched on, the UPDRS motor score improvement rate was 45.1% in the “OFF” state and 25.3% in the UP state motion score was not found in the “ON” state Any serious complications. Conclusions STN DBS is an effective method for the treatment of PD. The improvement of symptoms is obvious. The application of electrode locking device can reduce the complications of surgery.