Sidiskis Juozas
Clinic of Neurosurgery, Kaunas University of Medicine, Eiveniu 2, 3007 Kaunas, Lithuania.
Medicina (Kaunas). 2003;39(10):990-5.
There is no single opinion about the indications and best method of surgical treatment of Parkinson's disease. We presented the most common indications for surgery and evaluated the results of stereothalamotomies and stereopallidotomies, performed in our clinic, analyzed their effectiveness on the main motor symptoms of parkinsonism. During the last 29 years we performed 219 thalamotomies (45 bilateral) and 131 pallidotomies (23 bilateral) on 279 patients. Pallidotomy of the same side was repeated for 3 patients to correct the size of too small destruction and shortlasting effect. Good effect for parkinsonian tremor was achieved in 89.54% of patients after thalamotomies and in 77.42% after pallidotomies; for rigidity in 84.4% after thalamotomies and 83.15% after pallidotomies; for hypokinesia in 55% after pallidotomies and 6.5% after thalamotomies. In both types of operations the best effect was observed on the controlateral side. Bilateral effect (less on the ipsilateral side) was present in 5.17% of unilateral thalamotomies and in 14.28% of pallidotomies.
对于帕金森病的手术治疗指征和最佳方法,目前尚无统一意见。我们介绍了最常见的手术指征,并评估了在我们诊所进行的立体定向丘脑切开术和立体定向苍白球切开术的结果,分析了它们对帕金森病主要运动症状的疗效。在过去的29年里,我们对279例患者进行了219次丘脑切开术(45例双侧)和131次苍白球切开术(23例双侧)。对3例患者进行了同侧苍白球切开术的重复手术,以纠正毁损灶过小和效果持续时间短的问题。丘脑切开术后89.54%的患者帕金森震颤得到良好改善,苍白球切开术后为77.42%;丘脑切开术后84.4%的患者肌强直得到改善,苍白球切开术后为83.15%;苍白球切开术后55%的患者运动迟缓得到改善,丘脑切开术后为6.5%。在这两种手术中,对侧的效果最佳。单侧丘脑切开术的5.17%和苍白球切开术的14.28%出现双侧效果(同侧效果较弱)。