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脑下核外科手术并发症帕金森病的深度大脑刺激:800名患者的经验

Rozemarije A Holewijn¹, Yarit Wiggerts¹, Maarten Bot¹

¹Department of Neurosurgery, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, The Netherlands.

Stereotactic and functional neurosurgery

|June 27, 2024

概括

对帕金森病 (PD) 的深度大脑刺激 (DBS) 有1.0%的永久神经缺陷率. 25年来,手术并发症率有所下降,但修复手术仍然很重要.

科学领域:

神经外科神经外科
神经学神经学
医疗器械医疗器械

背景情况:

脑下核深度大脑刺激 (STN DBS) 是对帕金森病 (PD) 的治疗方法.
对于STN DBS的长期外科并发症数据对于患者咨询至关重要.

研究的目的:

分析手术并发症,包括神经缺陷和额外的手术,超过25年的STN DBS PD.
确定症状性脑内出血 (ICH) 的危险因素,并比较固定技术.

主要方法:

在1998年至2023年期间接受STN DBS的帕金森病患者的回顾性图表审查.
对并发症 (神经缺陷,额外的手术) 和潜在的ICH风险因素的分析.
固定技术的比较:固定装置与迷你板固定.

主要成果:

800名PD患者接受了STN DBS. 永久的神经缺陷发生在1.0%的患者中.
症状性脑内出血 (ICH) 发生在2.8%的患者中,其中0.6%导致永久性后果.
在研究期间,额外手术的发生率从27%降至13%. 感染率也有所下降.
与迷你板固定相比,固定装置的迁移显著减少.

结论:

帕金森病的STN DBS与永久神经缺陷 (1.0%) 的低率有关.
很大一部分患者需要在初始植入后进行额外的外科手术,尽管随着时间的推移,风险有所降低.
术前知情同意必须包括讨论潜在的手术风险和可能修复手术的必要性.

关键词:

大脑出血脑出血深度大脑刺激是什么?帕金森病是帕金森氏症的一种疾病.术后并发症术后并发症亚体体内核的细胞核

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