微电极记录技术在帕金森病手术治疗价值

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 1 999年 4月至 2 0 0 1年 2月采用微电极导向立体定向手术治疗帕金森病 350例 ,其中苍白球腹后部毁损术 (PVP) 2 78例 ,丘脑腹中间核 (Vim)毁损术 35例 ,同期同侧PVP和Vim毁损术 1 5例 ,行同期双侧PVP 1 1例 ,分期双侧PVP 8例 ,分期一侧PVP或另一侧Vim毁损术 3例。对手术前后的“关”状态和“开”状态进行生活能力评分、UPDRS评分 ,并进行门诊随访。结果　术后日常生活能力评分“关”状态提高 2 9.8% ,“开”状态提高 2 5 .9%。UPDRS :在“关”状态下 ,总的改善率为 57.3 % ,其中精神行为情绪改善率为 50 .8% ,日常活动改善率 59.1 % ,运动功能改善率 58.2 %。结论　PVP对震颤效果不如Vim毁损术 ,对震颤明显 ,无明显僵直的患者可选择Vim毁损术 ,对震颤僵直型患者可分期双侧PVP毁损术。

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

Objective To explore the value of stereotactic microelectrode recording on Parkinson's disease.Methods Three hundred and fifty patients with Parkinson's disease were underwent pallidotomy and thalamotomy from Apr ,1999 to Feb,2001.Of these patiens ,278 underwent a unilateral pallidotomy ,15 underwent bilateral pallidotomy,35 underwent thalamotomy,11underwent pallidotomy and thalamotomy ,11 underwent staged pallidotomy or thalamotomy.Results The UPDRS scale was used to assess patients in "on" and "off " drug conditions before and after surgery .UPDRS scale improved significantly on preoperation and postoperation .Conclusion Our findings show that pallidotomy much more effective than that thalamotoy for Parkinson's patient with tremor.The excellent combination of pallidotomy and thalamotomy is safe and effective therapy for Parkinson's disease.