帕金森病患者清醒状态下脑深部电刺激术的围手术期体验
Patients' Perioperative Experience of Awake Deep-Brain Stimulation for Parkinson Disease.
作者信息
Mulroy Eoin, Robertson Nigel, Macdonald Lorraine, Bok Arnold, Simpson Mark
机构信息
Department of Neurology, Auckland City Hospital, Auckland, New Zealand.
Department of Anesthesia, Auckland City Hospital, Auckland, New Zealand.
出版信息
World Neurosurg. 2017 Sep;105:526-528. doi: 10.1016/j.wneu.2017.05.132. Epub 2017 Jun 10.
BACKGROUND
Awake craniotomy for tumor resection and epilepsy surgery is a well-tolerated procedure. Qualitative data on patients' experience of awake deep-brain stimulation (DBS) are, however, lacking. We collected qualitative data on patients' experience of awake DBS with a view to identifying areas for improvement.
METHODS
Forty-one patients undergoing DBS for Parkinson disease between 2009 and 2015 were surveyed with a structured questionnaire designed to receive patient feedback regarding perioperative management of the awake stage of the procedure.
RESULTS
More than 90% of patients felt well-informed. Most remembered the procedure, and almost all were happy that they did. One half of the patients experienced pain, often significant, during the procedure. This mainly occurred during burr-hole drilling and stereotactic frame placement.
CONCLUSIONS
Although awake DBS is well-tolerated, pain and off-period symptoms are an issue for a significant number of patients. Efforts should be made to minimize these unpleasant aspects of awake DBS.
背景
清醒开颅肿瘤切除术和癫痫手术是耐受性良好的手术。然而，关于患者清醒状态下脑深部电刺激（DBS）体验的定性数据尚缺乏。我们收集了患者清醒状态下DBS体验的定性数据，旨在确定需要改进的方面。
方法
对2009年至2015年间41例接受帕金森病DBS治疗的患者进行了问卷调查，该问卷旨在收集患者对手术清醒阶段围手术期管理的反馈。
结果
超过90%的患者认为信息充分。大多数患者记得手术过程，几乎所有人都对自己接受了手术感到满意。一半的患者在手术过程中经历了疼痛，且往往较为严重。这主要发生在钻孔和立体定向框架放置过程中。
结论
尽管清醒状态下DBS耐受性良好，但疼痛和关期症状对相当多的患者来说是个问题。应努力将清醒状态下DBS这些令人不适的方面降至最低。
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