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首页> 外文期刊>Neurosurgery >Pallidotomy: a comparison of responders and nonresponders.
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Pallidotomy: a comparison of responders and nonresponders.

机译：苍白球切开术：有反应者和无反应者的比较。

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OBJECTIVE: We reviewed a prospective series of 32 unilateral, large-volume, microelectrode-guided posteroventral pallidotomies to determine the differences between responsive and nonresponsive patients. METHODS: Our patients underwent extensive pre- and postoperative evaluations. One year postoperatively, we correlated the outcomes of 25 patients with their histories, physical findings, neuropsychological assessments, and lesion characteristics to further understand the indications, limitations, and pitfalls of unilateral pallidotomy. Our group judged responsiveness by comparing the preoperative total Unified Parkinson's Disease Rating Scale off-state scores with those obtained 1 year postoperatively. A score indicating greater than 20% improvement at 1-year follow-up was rated a good outcome; improvement of greater than 40% was rated an excellent outcome. RESULTS: Although most patients sustained long-term benefits, some demonstrated little or no improvement. Patient and lesion factors influenced outcome. Younger age (<60 yr), tremor, unilateral predominance, L-dopa responsiveness, motor fluctuations with dyskinesia, and good lesion placement predicted a good response to unilateral pallidotomy. Advanced age (>70 yr), absence of tremor, increased duration of disease, reduced responsiveness to L-dopa, frontal behavioral changes, prominent apraxic phenomena, and improper lesion placement predicted a poor response. CONCLUSION: Unilateral, large-volume pallidotomy with precise lesion control provides long-lasting benefits for carefully selected patients.
机译：目的：我们回顾了前瞻性的32例单侧，大剂量，微电极引导的后腹腔切除术，以确定反应性和非反应性患者之间的差异。方法：我们的患者接受了广泛的术前和术后评估。术后一年，我们将25例患者的病史与他们的病史，体格检查结果，神经心理学评估和病变特征相关联，以进一步了解单侧苍白球切开术的适应症，局限性和陷阱。我们的小组通过比较术前统一帕金森氏疾病评分量表的州外评分与术后1年获得的评分来判断反应能力。评分表明，在一年的随访中改善了20％以上，被评为良好结果;大于40％的改善被认为是极好的结果。结果：尽管大多数患者可长期受益，但仍有部分患者无改善或无改善。患者和病变因素影响预后。年龄较小（<60岁），震颤，单方面优势，左旋多巴反应性，运动障碍伴运动障碍和良好的病变位置预示着对单侧苍白球切开术的良好反应。高龄（> 70岁），没有震颤，疾病持续时间增加，对左旋多巴的反应性降低，额叶行为改变，明显的过尖现象和病变放置不当预示了不良反应。结论：单侧大体积苍白球切开术具有精确的病灶控制，为精心挑选的患者提供了长期的益处。

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