运动障碍患者深部脑刺激硬件并发症：危险因素及临床相关性
Deep brain stimulation hardware complications in patients with movement disorders: risk factors and clinical correlations.
作者信息
Baizabal Carvallo José Fidel, Mostile Giovanni, Almaguer Mike, Davidson Anthony, Simpson Richard, Jankovic Joseph
机构信息
Parkinson's Disease Center and Movement Disorders Clinic, Department of Neurology, Baylor College of Medicine, Houston, TX 77030, USA.
出版信息
Stereotact Funct Neurosurg. 2012;90(5):300-6. doi: 10.1159/000338222. Epub 2012 Jul 12.
BACKGROUND
Deep brain stimulation (DBS) has proven to be an effective treatment for Parkinson's disease (PD) and other movement disorders, but its usefulness is limited by complications related to the hardware.
METHODS
We reviewed the records of all our patients treated with DBS from January 1996 to August 2010 and analyzed those with hardware complications and reasons for surgical revision.
RESULTS
A total of 512 patients underwent 856 electrode implantations during the study period. A total of 297 (58%) patients had PD, 127 (24.8%) had essential tremor (ET), 40 (7.8%) had dystonia, and 48 (9.37%) had another movement disorder. The mean age at the first electrode implantation was 57.6 ± 14 years and patients were followed for a mean of 3.9 ± 2.8 years. A total of 44 patients (8.6%) had a hardware complication or system revision. Lead fracture was the most common complication and occurred in 13 (2.5%) patients, followed by infections (n = 10, 1.9%), electrode misplacement (n = 10, 1.9%), electrode migration (n = 9, 1.75%), and other complications (n = 2 , 0.39%). Patients with ET had a higher risk of hardware complications compared to those with PD, 13 vs. 7% (OR 2.03; p = 0.042).
CONCLUSIONS
DBS is a safe intervention with a relatively low rate of hardware complications.
背景
深部脑刺激（DBS）已被证明是治疗帕金森病（PD）和其他运动障碍的有效方法，但其有效性受到与硬件相关并发症的限制。
方法
我们回顾了1996年1月至2010年8月期间所有接受DBS治疗的患者的记录，并分析了发生硬件并发症的患者及其手术翻修的原因。
结果
在研究期间，共有512例患者接受了856次电极植入。共有297例（58%）患者患有帕金森病，127例（24.8%）患有特发性震颤（ET），40例（7.8%）患有肌张力障碍，48例（9.37%）患有其他运动障碍。首次电极植入时的平均年龄为57.6±14岁，患者平均随访3.9±2.8年。共有44例患者（8.6%）出现硬件并发症或进行了系统翻修。导线断裂是最常见的并发症，发生在13例（2.5%）患者中，其次是感染（n = 10，1.9%）、电极误置（n = 10，1.9%）、电极移位（n = 9，1.75%）和其他并发症（n = 2，0.39%）。与帕金森病患者相比，特发性震颤患者发生硬件并发症的风险更高，分别为13%和7%（OR 2.03；p = 0.042）。
结论
DBS是一种安全的干预措施，硬件并发症发生率相对较低。
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