非痉挛型脑瘫的立体定向手术治疗(附16例报告)

目的探讨立体定向核团毁损术及脑深部电刺激术治疗非痉挛型脑瘫的疗效。方法将16例非痉挛型脑瘫病人分成三组：A组为肌张力障碍型，11例；B组为肌张力障碍合并震颤型，3例；C组为共济失调合并震颤型，2例。采用通用DT评分量表（GPS）评估病肢功能。分别采用立体定向核团毁损术及脑深部电刺激术治疗。术后随访1年，评估症状改善情况。结果A组肌张力障碍改善率为0—58．3％，平均17．1％；B组肌张力障碍改善率6．7％～25．0％，震颤改善率66．7％～75．0％；C组共济失调无明显变化，震颤改善率12．5％～25.0％。结论立体定向手术是治疗肌张力障碍型及震颤型脑瘫的可选择手段。

Stereotactic surgery for non-spastic cerebral palsy: a report of 16 cases

Objective To explore the clinical efficacy of stereotactic nucleus lesioning and deep brain stimulation for non-spastic cerebral palsy.Methods Sixteen non-spastic cerebral palsy patients were divided into three groups according to their clinical types.Stereotactic nucleus lesioning or deep brain stimulation was performed in 11 dystonia patients of group A,3 dystonia and tremor patients of group B,and 2 ataxia and tremor patients of group C.Global dystonia rating scale(GDS) was used to assess limb function.One-year follow-up was made for observing the improvement of symptoms in all the patients.Results The clinical improvement rate was 0-58.3%(mean 17.1%) for dystonia in group A,6.7%-25.0% for dystonia and 66.7%-75.0% for tremor in group B,and 12.5%-25.0% for tremor with no significant improvement of ataxia in group C.Conclusion Stereotactic surgery is a selective therapeutic method for non-spastic cerebral palsy.