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《丘腦底核腦深部電刺激對帕金森病術(shù)后藥物治療的影響 (附40例分析).doc》由會員上傳分享,免費(fèi)在線閱讀,更多相關(guān)內(nèi)容在工程資料-天天文庫。
1、丘腦底核腦深部電刺激對帕金森病術(shù)后為物治療的影響(附40例分析)【摘要】目的觀察帕金森病(PD)病人丘腦底核腦深部電刺激(STN-DBS)術(shù)后為物變化情況,探討STN-DBS對帕金森病術(shù)后藥物治療的影響。方法對接受STN-DBS手術(shù)治療的40例帕金森病病人手術(shù)前后的藥物服用劑量、藥物引起的相關(guān)并發(fā)癥等情況進(jìn)行PI顧性分析。結(jié)果本組經(jīng)6?49個月隨訪,多數(shù)病人在STN-DBS作用下因癥狀明顯改善,于開機(jī)后的1?6個月間使用抗PD藥物逐漸減量,最終的選擇劑量可維持2年以上。開機(jī)后5例不再服用相關(guān)藥物,25例藥物
2、較術(shù)前平均減少60%,7例藥物用量與術(shù)前相同,3例行單側(cè)STN-DBS者術(shù)后藥物用量增加。藥物相關(guān)并發(fā)癥因術(shù)后藥物用量的減少血得到明顯緩解。結(jié)論STN-DBS能夠減少術(shù)后抗PD藥物的用量,改善菊物引起的相關(guān)并發(fā)癥?!娟P(guān)鍵伺I】帕金森病丘腦底核深部腦刺激法左旋多巴EffectsofdeepbrainstimulationofthesubthalamicnucleusonthepostoperativeantiparkinsonianmedicationMAYul,ZHANGJianguo2,FENGTao3I
3、.DepartmentofNeurosurgery,FirstAffiliatedHospitalofChinaMedicalUniversity,Shenyang110001,China;2.DepartmentofNeurosurgery,3.DepartmentofNeurology,BeijingTiantanHospitalAffiliatedtoCapitalUniversityofMedicalSciences,Beijing100050,ChinaAbstract:ObjectiveToob
4、servethechangesinantiparkinsonianmedicationofParkinsondisease(PD)patientsafterdeepbrainstimulation(DBS)ofthesubthalamicnucleus(STN)andtodetermineeffectofSTN-DBSonantiparkinsonianmedication.MethodsThepre-andpost-operativeconditionsofantiparkinsonianmedicati
5、onandcomplicationsinducedbylevodopawereretrospectivelyanalyzedinPDpatientswhounderwentSTN-DBS.ResultsThepatientswerefollowedupfor6-49months.TheantiparkinsonianmedicationwasreducedgraduallyinmostofthePDpatientsduring1-6monthsafterSTN-DBS.Andthefinaldosageco
6、uldbekeptforatleast2years.Inthe40patients,25experiencedaverage60%reductioninantiparkinsonianmedication,7stillhadthesamedosageaspreoperativelyand5didnotneedmedicationanymore.Threepatientsundergoingone-sideSTN-DBSneededanincreaseddosage.Thecomplicationsinduc
7、edbylevodopawereremarkablyimprovedwiththereductionofantiparkinsonianmedication.ConclusionSTN-DBScouldreplacelevodopaandreducethedosageofantiparkinsonianmedicationpostoperatively,whichresultintheremarkableimprovementofcomplications.Keywords:Parkinsondisease
8、;subthalamicnucleus;deepbniinstimulation;levodopa丘腦底核(STN)腦深部電刺激術(shù)(DBS)能全面改善帕金森病(PD)各項癥狀,且能提供持續(xù)性的治療作用,術(shù)后統(tǒng)一帕金森病評定量表(UPDRS)評分無論”開”或”關(guān)”期均可得到顯著提高[1,2]0本研究通過對2001年4月?2005年6月在北京天壇醫(yī)院接受STN-DBS治療的40例PD病人術(shù)后服藥及相關(guān)情況進(jìn)行回顧性分