单侧丘脑底核电刺激治疗偏侧型帕金森病的长期疗效

摘要

目的 评估单侧丘脑底核(STN)脑深部电刺激(DBS)治疗偏侧型帕金森病的长期疗效.方法 回顾性分析23例偏侧型帕金森病病人的临床资料,均行单侧STN-DBS治疗,并分别于术前3～5 d、术后1年、术后5年以帕金森病统一评分量表( UPDRS)进行评估.结果 术后5年,病人在刺激“关”状态下,UPDRSⅡ、Ⅲ和轴性症状评分较术前明显升高(P＜0.05)；而刺激“开”状态下,UPDRSⅡ、Ⅲ和轴性部分评分较同期刺激“关”状态分别降低37.37％、41.14％和26.91％.与术前比较,术后5年平均每日口服左旋多巴等效剂量降低24.92％,而异动时间和异动病残度分别增加52.63％和59.65％.本组未发生手术相关并发症,随访期间出现发声困难6例.结论 对偏侧型帕金森病人,单侧STN-DBS是一种疗效持久的治疗方法.%Objective To access the long-term efficacy of unilateral subthalamic nucleus (STN) deep brain stimulation (DBS) for asymmetrical Parkinson's disease (PD). Methods Clinical data of 23 patients with asymmetrical PD were analyzed retrospectively. All the patients were performed of unilateral STN-DBS and accessed by the unified Parkinson's disease rating scale (UPDRS) 3-5 days before the operation, 1 year and 5 years after the operatioa Results Compared with the preoperation, the total scores of UPDRS Ⅱ, Ⅲ and axial part in off-stimulation state were significantly increased (P＜0.05). Compared with synchronous off-stimulation state, the total scores of UPDRS Ⅱ,Ⅲ and axial part were decreased by 37.37%, 41.14% and 26.91% respectively 5 years after the operation. Compared with the preoperation, the average Ievodopa-equivalent daily dosage was decreased by 24.92%, but the time and disability degree of dyskinesia were increased by 52.63% and 59.65% respectively 5 years after the operation. No complications related to the operation occurred, but dysphonia was observed in 6 patients during the follow-up period. Conclusions Unilateral STN-DBS is an effect-durable treatment method for asymmetrical PD patients.