关键词: 帕金森病;震颤;丘脑;立体定位手术

    摘 要:目的 探讨选择性丘脑腹中间核(Vim)毁损术的手术方法及对震颤型帕金森病的疗效. 方法 CT解剖定位，微刺激、微记录及放大刺激进行神经电生理校对，行小灶性毁损.手术前后行UPDRS分项计分、手指拍击实验和行走试验并计算改善率. 结果 33例震颤型帕金森病患者术中完全控制震颤.UPDRS分项计分、手指拍击实验和行走试验及改善率均显示手术疗效显著.2wk后复发1例.轻度构音障碍1例. 结论 选择性丘脑Vim毁损术对震颤型帕金森病有显著疗效.严格掌握手术适应证，合理应用微电极技术，适当的毁损体积是手术成功的关键.

    Selective ventralis intermedius nucleus thalamotomy for medically refractory tremor of parkinson's dis┐ease patients

    ZHAO Ya-Qun，GAO Guo-Dong，WANG Xue-Lian，ZHANG Hua

    Department of Neurosurgery，Tangdu Hospital，Fourth Military Medical University，Xi'an710038，China

    Keywords:parkinson disease;tremor;thalamus;stereotaxic techniques

    Abstract:AIM To discuss the method and the outcome of selective ventralis intermedius nucleus thalamotomy for medi-cally refractory tremor of Parkinson's disease patients.METHODS After anatomical localization with spiral CT and comfirming the target by microstimulation，microrecording and marcostimulation a small lesion was made.Subcompo-nents of the UPDRS ......