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远程脑深部刺激程控在帕金森病患者中的应用。

Application of Remote Deep Brain Stimulation Programming for Parkinson's Disease Patients.

机构信息

Neuromodulation Center, Yuquan Hospital, Tsinghua University, Beijing, China.

Neuromodulation Center, Yuquan Hospital, Tsinghua University, Beijing, China.

出版信息

World Neurosurg. 2021 Mar;147:e255-e261. doi: 10.1016/j.wneu.2020.12.030. Epub 2020 Dec 13.

Abstract

BACKGROUND

Deep brain stimulation (DBS) is an important treatment for patients with advanced Parkinson's disease (PD). Patients after DBS implantation need specialized programming to get optimal outcomes. However, access to timely and economical postoperative programming for many patients living in remote areas is limited. Teleprogramming, which refers to deliver real-time remote programming through Internet, can help to address this gap.

OBJECTIVE

We aimed to evaluate the clinical application of remote programming for PD patients with DBS.

METHODS

We retrospectively studied 90 patients with PD who received remote DBS programming after implantation at Yuquan Hospital (Beijing, China) between March 2016 and June 2018. Patients' medical records were reviewed in an electronic database. A self-designed questionnaire was performed on all patients by phone.

RESULTS

Over a mean follow-up period of 27.0 months, 90 patients underwent a total of 386 remote programming visits, of which the average frequency within 6 months after DBS was 2.27 times/person. The average distance between the patients' residences and Yuquan Hospital was 1243.8 ± 746.5 km. The questionnaire survey showed that each remote programming visit saved ≥2000¥ for 76.7% of the patients and ≥12 hours for 90.0% of the patients, compared with the on-site programming visit. The acceptability of the remote programming platform was highly rated. Transient side effects related to programming were reported and were relieved after adjustments of parameters.

CONCLUSIONS

Remote programming may offer a feasible and acceptable approach to timely and economic management in patients with PD after DBS implantation.

摘要

背景

脑深部电刺激(DBS)是治疗晚期帕金森病(PD)患者的重要手段。DBS 植入术后患者需要进行专门的程控以获得最佳疗效。然而,对于许多居住在偏远地区的患者来说,获得及时和经济的术后程控服务是有限的。远程程控是指通过互联网实现实时远程程控,可以帮助解决这一差距。

目的

我们旨在评估远程程控在 DBS 治疗 PD 患者中的临床应用。

方法

我们回顾性研究了 2016 年 3 月至 2018 年 6 月期间在北京玉泉医院接受 DBS 植入后远程 DBS 程控的 90 例 PD 患者。通过电子数据库对患者的病历进行了回顾。通过电话对所有患者进行了自行设计的问卷调查。

结果

在平均 27.0 个月的随访期间,90 例患者共进行了 386 次远程程控访问,其中 DBS 后 6 个月内的平均频率为 2.27 次/人。患者居住地与玉泉医院的平均距离为 1243.8±746.5km。问卷调查显示,与现场程控访问相比,每次远程程控访问可为 76.7%的患者节省≥2000 元,可为 90.0%的患者节省≥12 小时。远程程控平台的可接受性得到了高度评价。报告了与编程相关的短暂副作用,并在调整参数后得到缓解。

结论

远程程控可能为 DBS 植入后 PD 患者的及时和经济管理提供一种可行且可接受的方法。

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