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）.doc

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1、丘脑底核脑深部电刺激对帕金森病术后为物治疗的影响(附40例分析)【摘要】目的观察帕金森病(PD)病人丘脑底核脑深部电刺激(STN-DBS)术后为物变化情况，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PI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

2、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血得到明显缓解。结论STN-DBS能够减少术后抗PD药物的用量，改善菊物引起的相关并发症。【关键伺I】帕金森病丘脑底核深部脑刺激法左旋多巴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丘脑底核(STN)脑深部电刺激术(DBS)能全面改善帕金森病(PD)各项症状，且能提供持续性的治疗作用，术后统一帕金森病评定量表(UPDRS)评分无论”开”或”关”期均可得到显著提高[1,2]0本研究通过对2001年4月〜2005年6月在北京天坛医院接受STN-DBS治疗的40例PD病人术后服药及相关情况进行回顾性分