CAJ | 학술논문

目的分析丘脑底核脑深部电刺激术(STN-DBS)对帕金森病(PD)的疗效和STN-DBS刺激参数调节的方法. 方法南京医科大学附属脑科医院神经内科自2012年2月至2012年12月采用STN-DBS手术治疗PD患者6例,应用统一帕金森病评分量表(UPDRS)Ⅰ、Ⅱ、Ⅲ、Ⅳ评分分析STN-DBS手术前后患者的症状变化并记录刺激器参数. 结果与术前比较,患者术后1月时UPDRS Ⅰ评分无明显变化,差异无统计学意义(P＞0.05)；UPDRSⅡ、Ⅲ和Ⅳ评分均降低,差异有统计学意义(P＜0.05).患者均采用单极刺激,刺激频率均≥130 Hz,电压为(1.972±0.231)V,脉宽为90～120 μs.术后随访2～8个月,所有患者症状改善稳定,无与刺激相关的并发症. 结论 STN-DBS可有效的改善中晚期PD患者的运动症状,提高生活质量.程控时,在高频率刺激下,可根据单位脉冲的能量(V·μs)值来调节电压和脉宽.
목적 분석구뇌저핵뇌심부전자격술(STN-DBS)대파금삼병(PD)적료효화STN-DBS자격삼수조절적방법. 방법 남경의과대학부속뇌과의원신경내과자2012년2월지2012년12월채용STN-DBS수술치료PD환자6례,응용통일파금삼병평분량표(UPDRS)Ⅰ、Ⅱ、Ⅲ、Ⅳ평분분석STN-DBS수술전후환자적증상변화병기록자격기삼수. 결과 여술전비교,환자술후1월시UPDRS Ⅰ평분무명현변화,차이무통계학의의(P＞0.05)；UPDRSⅡ、Ⅲ화Ⅳ평분균강저,차이유통계학의의(P＜0.05).환자균채용단겁자격,자격빈솔균≥130 Hz,전압위(1.972±0.231)V,맥관위90～120 μs.술후수방2～8개월,소유환자증상개선은정,무여자격상관적병발증. 결론 STN-DBS가유효적개선중만기PD환자적운동증상,제고생활질량.정공시,재고빈솔자격하,가근거단위맥충적능량(V·μs)치래조절전압화맥관.
Objective To analysis the effect of subthalamic nucleus deep brain stimulation (STN-DBS) on Parkinson's disease (PD) and the regulatory strategies of these stimulation parameters.Methods Six patients with PD,admitted to and received STN-DBS in our hospital from February 2012 to December 2012,were chosen in our study; the clinical symptoms of all patients were evaluated by Unified Parkinson's Disease Rating Scale (UPDRS) before and 1 mouth after STN-DBS operation;stimulation parameters were also recorded.Results The UPDRS Ⅰ scores of these patients were not significantly different between before and 1 month after STN-DBS (P＞0.05).As compared with those before surgery,the UPDRS Ⅱ,Ⅲ and Ⅳ scores of these patients 1 month after STN-DBS were significantly decreased (P＜0.05).All patients received unipolar stimulation with stimulus frequencies of equal to or greater than 130 Hz,stimulus voltages of 1.97±0.23 V and stimulus pulses of 90-120 μs.Follow-up was performed for 2～8 months,showing stable symptoms and no stimulation-related complications in all the patients.Conclusion STN-DBS could significantly improve the motor function and living quality on medium-late term PD patients; under high-frequency stimulation,the voltage and pulse width could be programmed by the energy per pulse (V· μs) value.