丘脑底核慢性电刺激与苍白球毁损术治疗帕金森病疗效比较

目的分别应用脑深部电刺激(deepbrainstimulation,DBS)和苍白球毁损术(posteroventralpallidot-omy,PVP)治疗原发性帕金森病(Parkinson'sdisease,PD),对照研究DBS和PVP对PD患者的震颤、肢体僵硬、运动迟缓的疗效。方法应用CT影像学与微电极电生理定位结合的方法进行靶点定位,为11例帕金森病患者进行同期双侧丘脑底核电极植入,26例患者进行分期双侧苍白球腹后部毁损术,经过至少6个月的随访并行UPDRS评分。结果11例同期进行双侧丘脑底核电极植入及26例分期进行双侧苍白球毁腹后部毁损术患者术后的震颤、肢体僵硬、运动迟缓症状均不同程度的改善,但以DBS手术的改善程度更为明显,两组患者手术前后的UPDRS评分下降程度差异显著(P<0.05)。结论双侧同期DBS是目前治疗PD相对较好的方法,双侧电极植入在改善肢体症状的同时可以明显控制、改善中轴症状,在治疗中晚期PD患者方面较PVP有较大的优势。

Comparison of deep brain stimulation and pallidotomy for Parkinson's disease

Objective To compare the efficacy of the Deep Brain Stimulation and the Pallidotomy in treatment of Parkinson's disease.Methods 11 patients with PD underwent bilateral DBS in one operation,26 patients underwent Pallidotomy bilateral by stage.The efficacy was estimated at least six months later by UPDRS score.Results All patients got improvements in different level.The DBS team got more significant improvements.And the bradykinesia improved obviously in the DBS team.The patients' decreases of UPDRS score were different obviously.Conclusion The bilateral DBS is a better method for PD compared with PVP,especially for patients suffering from bradykinesia.