[1]陈昱升,崔桂云.丘脑底核脑深部刺激术治疗帕金森病静止性震颤的疗效分析[J].徐州医科大学学报,2019,39(12):913-916.
 Deep brain stimulation of the subthalamic nucleus in the treatment of static tremor in Parkinson’’s disease[J].Journal of Xuzhou Medical University,2019,39(12):913-916.
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丘脑底核脑深部刺激术治疗帕金森病静止性震颤的疗效分析()
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《徐州医科大学学报》[ISSN:2096-3882/CN:32-1875/R]

卷:
39
期数:
2019年12期
页码:
913-916
栏目:
出版日期:
2019-12-25

文章信息/Info

Title:
Deep brain stimulation of the subthalamic nucleus in the treatment of static tremor in Parkinson’’s disease
作者:
陈昱升崔桂云
文献标志码:
A
摘要:
【摘要】目的 探讨丘脑底核深部脑刺激术(STN-DBS)对原发性帕金森病的疗效,重点分析静止性震颤的改善情况。方法 43例行双侧STN-DBS治疗的原发性帕金森病患者,术后随访平均24.5个月。具体如下:① 统计DBS手术对UPDRSⅢ运动评分、H-Y分期及静止性震颤的改善情况。②从多巴胺药物反应型及药物无反应型、左侧肢体起病型与右侧肢体起病型及上肢、下肢、下颌/嘴唇震颤等三个维度重点分析具体的静止性震颤的疗效。③统计震颤的程控参数,研究程控参数与帕金森病静止性震颤改善的相关性。结果 术后随访显示:H-Y分期下降0.70±0.58期,UPDRSⅢ运动评分改善47.83%,震颤改善70.19%。具体分析震颤改善率:药物反应型为69.16%、无反应型76.58%;左侧起病型为60.78%、右侧起病型76.35%;上肢为85.97%、下肢70.77%、下颌/嘴唇53.23%。术后程控需要130Hz以上的高频刺激震颤才能得到很好改善。结论 STN-DBS治疗原发性帕金森病运动症状疗效显著,UPDRSⅢ运动评分及震颤明显改善,H-Y分期下降。但具体的静止性震颤改善率,多巴胺药物无反应型好于反应型、右侧肢体起病者好于左侧肢体起病者、上肢好于下肢及头部。震颤的程控仍然以高频刺激为主,其次为高电压。
Abstract:
【Abstract】 Objective We investigate the effect of STN-DBS on primary Parkinson’’s disease. The improvement of static tremor was emphatically analyzed. Methods 43 patients with primary Parkinson’’s disease treated with bilateral STN-DBS were followed up for an average of 24.5 months. Details are as follows: ①The improvement of UPDRS exercise score H-Y stage and static tremor after DBS operation was calculated. ②The effects of specific static tremor were analyzed from three dimensions including dopamine-responsive and drug-non-responsive left limb onset and right limb onset and upper limb mandibular/lip tremor. ③The program-controlled parameters of tremor were counted to study the correlation between program-controlled parameters and the improvement of static tremor in Parkinson’’s disease. Results Postoperative follow-up showed that h-y stage decreased by 0.70 0.58 stage, UPDRS exercise score improved by 47.83% and tremor improved by 70.19%. The left onset type was 60.78% and the right onset type was 76.35%. Upper extremity 85.97% lower extremity 70.77% lower extremity 53.23% lower extremity 70.77% lower extremity 53.23% postoperative program control requires high frequency stimulation tremor of more than 130Hz to get a good improvement. Conclusion STN-DBS had a significant effect on the treatment of motor symptoms of primary Parkinson’’s disease, the UPDRS exercise score and tremor were significantly improved, the h-y stage was decreased, but the specific improvement rate of static tremor was improved. The dopamine-free type was better than the reactive type in the patients with right limb onset than the reactive type in the patients with left limb onset in the upper limb and the lower limb and the head. The program control of tremor is still dominated by high frequency stimulation, followed by high voltage.
更新日期/Last Update: 2020-01-06