Gray Alastair, McNamara Iain, Aziz Tipu, Gregory Ralph, Bain Peter, Wilson Joanna, Scott Richard
Health Economics Research Centre, Department of Public Health, University of Oxford, Oxford, United Kingdom.
Mov Disord. 2002 Jan;17(1):68-75. doi: 10.1002/mds.1259.
We assessed the impact of surgical treatment of Parkinson's disease on quality of life using generic quality of life instruments and utility scores. The Medical Outcomes Study short form health survey SF-36 and Parkinson's Disease Questionnaire PDQ-39 were used before and 3-6 months after surgery to assess quality of life, and the results were converted into utility valuations. Ninety-seven patients were studied; 33 underwent unilateral thalamotomy, 33 unilateral pallidotomy, 20 bilateral pallidotomy, six subthalamic nucleus (STN) lesions, four mixed lesions, and in one case bilateral STN stimulation. All dimensions of the SF-36 except role mental and mental health showed statistically significant improvement following surgery. The PDQ-39 recorded significant improvements in the mobility, stigma, and bodily discomfort dimensions. The rating scale and time trade-off scales showed statistically significant gains in utility of 8% and 3%, respectively. Gains were particularly marked in the bilateral pallidotomy group. Differences in patient characteristics and selection made direct comparisons between procedures unreliable. Quality of life in patients with advanced Parkinson's disease is amenable to measurement; such measurement provides tentative evidence of significant gains in quality of life following some neurosurgical procedures.
我们使用通用生活质量量表和效用评分评估帕金森病手术治疗对生活质量的影响。在手术前及术后3至6个月,采用医学结果研究简表健康调查SF - 36和帕金森病问卷PDQ - 39评估生活质量,并将结果转换为效用估值。对97例患者进行了研究;其中33例行单侧丘脑切开术,33例行单侧苍白球切开术,20例行双侧苍白球切开术,6例行丘脑底核(STN)毁损术,4例行混合毁损术,1例行双侧STN刺激术。术后,SF - 36除角色心理和心理健康维度外的所有维度均有统计学意义的改善。PDQ - 39记录了运动、耻辱感和身体不适维度的显著改善。评分量表和时间权衡量表显示效用分别有8%和3%的统计学显著提高。双侧苍白球切开术组的改善尤为明显。患者特征和选择的差异使得不同手术之间的直接比较不可靠。晚期帕金森病患者的生活质量是可测量的;这种测量为一些神经外科手术后生活质量的显著提高提供了初步证据。