丘脑底核脑深部电刺激对帕金森病术后药物治疗的影响(附40例分析)

目的 观察帕金森病（PD）病人丘脑底核脑深部电刺激（STN—DBS）术后药物变化情况。探讨STN—DBS对帕金森病术后药物治疗的影响。方法 对接受STN—DBS手术治疗的40例帕金森病病人手术前后的药物服用剂量、药物引起的相关并发症等情况进行回顾性分析。结果 本组经6～49个月随访。多数病人在STN-DBS作用下因症状明显改善，于开机后的1-6个月间使用抗PD药物逐渐减量。最终的选择剂量可维持2年以上。开机后5例不再服用相关药物。25例药物较术前平均减少60％。7例药物用量与术前相同，3例行单侧STN—DBS者术后药物用量增加。药物相关并发症因术后药物用量的减少而得到明显缓解。结论 STN—DBS能够减少术后抗PD药物的用量。改善药物引起的相关并发症。

Effects of deep brain stimulation of the subthalamic nucleus on the postoperative antiparkinsonian medication

Objective To observe the changes in antiparkinsonian medication of Parkinson disease(PD) patients after deep brain stimulation(DBS) of the subthalamic nucleus(STN) and to determine effect of STN-DBS on antiparkinsonian medication.Methods The pre-and post-operative conditions of antiparkinsonian medication and complications induced by levodopa were retrospectively analyzed in PD patients who underwent STN-DBS.Results The patients were followed up for 6-49 months.The antiparkinsonian medication was reduced gradually in most of the PD patients during 1-6 months after STN-DBS.And the final dosage could be kept for at least 2 years.In the 40 patients,25 experienced average 60% reduction in antiparkinsonian medication,7 still had the same dosage as preoperatively and 5 did not need medication any more.Three patients undergoing one-side STN-DBS needed an increased dosage.The complications induced by levodopa were remarkably improved with the reduction of antiparkinsonian medication.Conclusion STN-DBS could replace levodopa and reduce the dosage of antiparkinsonian medication postoperatively,which result in the remarkable improvement of complications.