微电极导向立体定向手术治疗帕金森病

目的：总结微电极导向立体定向手术治疗帕金森病的临床经验及治疗效果。方法：自1999年4月至2001年2月采用微电极导向立体定向手术治疗帕金森病350例。其中行苍白球腹后部毁损术（PVP）278例,丘脑腹中间核（Vim)毁损术35例,行同期同侧PVP和Vim毁损术15例,行同期双侧PVP11例,分期双侧PVP8例,分期一侧PVP、另一侧Vim毁损术3例。对手术前后的“关”状态和“开”状态进行日常生活量表评分、统一帕金森病评定量表（UPDRS）评分,并进行门诊随访或家访。结果：术后日常生活能力评分“关”状态提高29．8％,“开”状态提高25．9％。UPDRS评分在“关”、“开”状态下,总的症状改善率分别为57．3％和33．4％,其中精神行为情绪改善率为50．8％和28．9％,日常活动改善率为59．1％和35．9％,运动功能改善率为58．2％和34．7％。结:PVP地大多数症状均有效,但对震颤的效果不如Vim毁损术;对震颤明显、无明显僵直的患可选择Vim毁损术;对震颤僵直型患可行同期双侧PVP或同期PVP加Vim毁损术。

The application of microelectrode recording during operation for Parkinson's disease

Objective: : To explore the effects of stereotact ic microelectrode recording on surgery for Parkinson's disease. Methods: Three hundred and fifty patients with Parkinson's disease received palli dotomy and/or thalamotomy from Apr,1999 to Feb, 2001. Of these patients, 278 und erwent a unilateral pallidotomy, 35 underwent thalamotomy, 15 underwent simultan eous unibilateral pallidotomy and thalamotomy, 11 underwent simultaneous bilater al pallidotomy,11 underwent staged bilateral pallidotomy or thalamotomy. The UPD RS scale was used to assess patients in "on"- and "off" -drug conditions b efore and after operation. Results: After operation Schwab and E ngland of daily living scale improved by 29.8% in "off" status and by 25.9% in "on" status, the UPDRS scale improved by 57.3% in "off" status and by 33.4% in "on" status. Conclusion: Pallidotomy is much more effectiv e than thalamotomy for Parkinson's patients with tremor.The combination of palli dotomy and thalamotomy is safe and effective for Parkinson's disease.