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目的:探讨双侧丘脑底核电刺激(STN-DBS)改善帕金森病(PD)患者“关”期运动障碍疗效和安全性评估。方法:对接受双侧STN-DBS治疗的57例PD患者进行前瞻性研究。分别在术后1年和3年,应用UPDRS和Schwab&England评分对患者进行“关”期运动功能以及安全性评估。结果:与术前比较,在“关”期评分中,术后1年患者的运动功能评分改善60%;术后3年改善51%;除语言改善不明显外,震颤、肌肉强直、运动不能以及姿势稳定性等均有较大改善。术后3年多巴胺类药物的服用剂量、左旋多巴所致运动障碍的持续时间和严重程度都有明显减轻(P<0.001)。术后1年日常生活能力改善61%,术后3年改善50%。严重的不良事件为1例丘脑出血。结论:双侧STN-DBS治疗显著改善PD患者“关”期运动障碍,安全性好。
Objective: To evaluate the efficacy and safety of bilateral subthalamic nucleus stimulation (STN-DBS) in improving Parkinson’s disease (PD) patients with exercise-induced dyskinesia. Methods: A prospective study of 57 patients with PD treated with bilateral STN-DBS was performed. Patients were evaluated for motor function and safety by UPDRS and Schwab & England scores 1 and 3 years after surgery, respectively. Results: Compared with the preoperative score, the score of motor function improved 60% at 1 year postoperatively and 51% 3 years postoperatively. In addition to the language improvement was not obvious, tremor, muscle rigidity, Movement can not pose stability and so have greatly improved. The dose of dopamine and the duration and severity of levodopa-induced dyskinesia were significantly reduced after 3 years (P <0.001). Improvement of daily living ability by 61% 1 year after surgery and 50% improvement after 3 years. A serious adverse event was thalamic hemorrhage. CONCLUSIONS: Both STN-DBS treatment can significantly improve the motor dysfunction in PD patients and have good safety.