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双侧丘脑底核脑深部电刺激术治疗帕金森病有效性和安全性的meta分析
作者: 冼文彪 裴中 周旭毓 陈玲
单位:冼文彪,裴中,陈玲(中山大学附属第一医院神经科,广州,510080)周旭毓(中山大学医学情报研究所)
关键词: 脑深部电刺激术 丘脑底核 帕会森病 meta分 析帕金森病统一评分量表
分类号:
出版年·卷·期(页码):2009·35·第 5 期(0-0)
摘要:
目的 系统评价双侧丘脑底核脑深部电刺激术(subthalamic nucleus deep brain stimulation,STN-DBS)治疗帕金森病的临床疗效和副作用.方法 通过检索国内外文献数据库,检索2009年4月前已发表的关于双侧STN DBS治疗帕金森病的临床研究.对所纳入的研究进行系统评价.结果 共纳入27项临床研究(纳入900例患者).对随访1年病例进行meta分析.结果 显示术后单纯STN DBS治疗与术前单纯服药治疗两种方案对UPDRSⅢ以及震颤.强卣的改善无统计学差异(P>0.05);而STN-DBS治疗对UP-DRSⅡ、步态、运动迟缓改善不如术前服药(P0.05).在STN-DBS副作用方面,手术导致颅内出血的发生率(3.7%)及死亡串(0.7%)等风险较低;较常见的为刺激导致的短暂的副作用:体重增加(18.8%)、构音障碍(14.9%)、睁眼困难(5.7%)、抑郁(8.2%)及智能减退(4.0%),大部分可经调节刺激参数后改善.结论 STN-DBS联台药物治疗可显著改善帕金森病患者症状,并减少治疗药物的剂量以及药物所致的副作用;STN-DBS副作用较少,安全性高.
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