| 立体定向手术治疗顽固性中枢神经痛 |
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| 引用本文： | 王林,陈国强,田宏,王岩,冯增伟,韩红彦,王晓松.立体定向手术治疗顽固性中枢神经痛[J].立体定向和功能性神经外科杂志,2009(4). |
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| 作者姓名： | 王林 陈国强 田宏 王岩 冯增伟 韩红彦 王晓松 |
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| 作者单位： | 清华大学玉泉医院神经外科; |
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| 基金项目： | 清华大学裕元科学基金项目(编号:20240000534) |
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| 摘 要： | 目的研究脑立体定向手术治疗顽固性中枢神经痛(central pain,CP)的临床应用。方法CP患者6例,包括丘脑及脑桥梗塞4例,丘脑出血1例,丘脑梗塞合并颈髓损伤1例。所有病例均在局麻下行双侧扣带回及双侧伏核(nucleus accumbens,NAc)毁损。手术前后采用视觉模拟评分(visual analog scale,VAS)、McGill疼痛问卷(mcGill pain questionnaire,MPQ),口述描绘评分法(verbal rating scales,VRS)进行评分,同时记录手术前后患者使用镇痛剂的种类和最大剂量。将术后1周,1个月,3个月,6个月的评分和术前比较,采用自身配对t检验。结果术后6例患者从1周到6个月止痛效果较好,最长1例随访18个月,止痛效果稳定,除1例丘脑出血后疼痛患者目前偶尔口腹止痛片外,其余患者到目前为止未用任何麻醉镇痛剂治疗。VAS,MPQ,PPI,VRS评分手术前后差异显著(P<0.01)。结论脑立体定向双侧伏核+双侧扣带回损毁手术治疗CP具有较好的治疗效果,超过1年的长期疗效有待进一步观察。
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| 关 键 词： | 中枢神经痛 立体定向手术 伏核 扣带回 |
Stereotactic neurosurgery for intractable central pain |
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| Wang Lin,Chen Guoqiang,Tian Hong,et al..Stereotactic neurosurgery for intractable central pain[J].Chinese Journal of Stereotactic and Functional Neurosurgery,2009(4). |
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| Authors: | Wang Lin Chen Guoqiang Tian Hong |
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| Institution: | Wang Lin,Chen Guoqiang,Tian Hong,et al.Department of Neurosurgery,The Affiliated Yuquan Hospital of Tsinghua University,Beijing,100049. |
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| Abstract: | Objective To study the stereotactic neurosurgery for the treatment of intractable central pain(CP).Methods 6 patients with CP were employed clinically including 4 cases of thalamus or pontine infarction,one case of thalamus haemorrhage,another case of thalamus infarction and cervical cord injury.Bilateral nucleus accumbens and anterior cingulate gyrus lesion were co-performed in 6 patients.Statistical analyses were conducted using paired t test.Results The short-term(6 months)follow-up results showed a sign... |
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| Keywords: | Central pain Stereotactic neurosurgery Nucleus accumbens Cingulate gyrus |
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