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目的 评估微电极导向多靶点毁损术的手术疗效及不同手术方式的适应证选择。方法 应用微电极导向多靶点毁损术治疗帕金森病 83例 ,其中同期双侧苍白球毁损 1 0例 ,同期同侧苍白球加丘脑毁损 3 0例 ,分期双侧多靶点毁损43例。以术前及术后 1周UPDRS积分计算改善率评价疗效。结果 83例均有显著近期疗效 ,其中同期双侧毁损的改善率为 83 4% ,同期同侧毁损的改善率为 78 5% ,分期双侧毁损的改善率为 85 2 %。术后 3 6%出现轻度并发症。单项症状改善率最高为僵直 (95 7% ) ,余依次为震颤 (95 1 % )、行动迟缓 (90 9% )、步态 (70 % )、平衡 (68% )。平均随访 1年 ,除 1例复发外 ,余疗效均稳定。结论 微电极导向多靶点毁损术是治疗帕金森病的最有效方法 ,根据手术适应证选择手术方案有助于提高疗效。
Objective To evaluate the efficacy of microelectrode-guided multi-target surgery and the indications for different surgical procedures. Methods Eighty-three patients with Parkinson’s disease were treated with microelectrode-guided multi-target debridement, including 10 cases of bilateral globus pallidus, 30 cases of ipsilateral globus pallidus and thalamic damage in the same period, and 43 cases of bilateral multi-target destruction in the same period. Preoperative and postoperative 1 week UPDRS points calculated improvement rate evaluation effect. Results All the 83 cases had significant short-term curative effect. The improvement rate of bilateral lesion in the same period was 83 4%, while the improvement rate of ipsilateral lesion in the same period was 78 5%. The improvement rate of bilateral lesion in stage was 85 2%. 36% postoperative mild complications. The single symptom improvement rate was the highest (95.7%), followed by tremor (95.1%), slowness (90.9%), gait (70%) and balance (68%). The average follow-up of 1 year, except for 1 case of recurrence, the rest were stable. Conclusion Microelectrode-guided multi-target debridement is the most effective method for the treatment of Parkinson’s disease. Choosing the surgical protocol according to the indications of surgery will help to improve the curative effect.