生命末期的深部脑刺激：临床和伦理考虑。
Deep Brain Stimulation at End of Life: Clinical and Ethical Considerations.
机构信息
Center for Bioethics, Cleveland Clinic, Cleveland, Ohio.
Center for Neurological Restoration, Cleveland Clinic, Cleveland, Ohio.
出版信息
J Palliat Med. 2020 Apr;23(4):582-585. doi: 10.1089/jpm.2019.0129. Epub 2019 Aug 12.
Abstract
Deep brain stimulation (DBS) is an implanted neurological device effective in treating motor symptoms of Parkinson disease (PD), such as tremor, rigidity, and bradykinesia. More than 150,000 patients worldwide have been implanted with DBS devices. Questions arise at the end of life concerning how to provide best care for patients with DBS, including its continued benefit or potential complications, yet, no published articles provide guidance for hospice providers regarding the management of DBS devices in end-of-life care. With contributions from hospice physicians, a neurosurgeon, and ethicists, this article provides recommendations to address clinical and ethical challenges in optimizing DBS for patients with PD nearing the end of life.
摘要
脑深部电刺激术（DBS）是一种植入式神经调节装置，可有效治疗帕金森病（PD）的运动症状，如震颤、僵硬和运动迟缓。目前全球已有超过 15 万名患者接受了 DBS 装置的植入。在生命末期，人们会对如何为接受 DBS 治疗的患者提供最佳护理产生疑问，包括其持续获益或潜在并发症等问题，但目前尚无任何已发表的文章为临终关怀提供者提供关于 DBS 装置在临终关怀管理方面的指导。本文由临终关怀医生、神经外科医生和伦理学家共同撰写，为优化 PD 患者接近生命末期的 DBS 治疗提供了临床和伦理方面的建议。
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