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1、丘腦底核腦深部電刺激對帕金森病術后為物治療的影響(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)術后為物變化情況，探討STN-DBS對帕金森病術后藥物治療的影響。方法對接受STN-DBS手術治療的40例帕金森病病人手術前后的藥物服用劑量、藥物引起的相關并發(fā)癥等情況進行PI顧性分析。結果本組經6?49個月隨訪，多數病人在STN-DBS作用下因癥狀明顯改善，于開機后的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。開機后5例不再服用相關藥物，25例藥物
2、較術前平均減少60%,7例藥物用量與術前相同，3例行單側STN-DBS者術后藥物用量增加。藥物相關并發(fā)癥因術后藥物用量的減少血得到明顯緩解。結論STN-DBS能夠減少術后抗PD藥物的用量，改善菊物引起的相關并發(fā)癥?！娟P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(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，術后統(tǒng)一帕金森病評定量表(UPDRS)評分無論”開”或”關”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病人術后服藥及相關情況進行回顧性分
