An Analysis Of Long-term Curative Effect Of The Posteroventral Pallidotomy For The Parkinson's Disease

Objective To explore the long-term curative effect and some laws of the posteroventral pallidotomy(PVP) for the Parkinson's Disease(PD).Method Seventy-nine patients with PD had been tracked since 1998. In these patients, Fifty-eight patients (PVP group) had undergone posteroventral pallidotomy and twenty-one patients (non-PVP group)had never accepted any surgery for PD. The score of Unified Parkinson's Disease Rating Scale (UPDRS) of PVP group had been recorded before the operation and in less than 1 year, 1 year, 2 year, 3 year and 4 year after the operation. we also had recorded the score of UPDRS of non-PVP group at the time of visitation and in less than 1 year, 1 year, 2 year, 3 year and 4 year after the visitation. The results of follow-up were analyzed with statistics and statistic software. Acoording to these statistic data, we try to make a scientific evaluation about the short-term and long-term curative effect of PVP for the PD.Results There are notable difference among the score of UPDRS before PVP, the one in the short-term after PVP and the one in the long-term after PVP (p<0.001).The long-term follow-up review show that the score of UPDRS of PVP group increase more slowly than that of non-PVP group(p<0.05). The short-term effect of PVP (1) had relationship with the age at the time of operation (X2)and the severity of PD before the operation (X6). The multiple linear regression equations are as follows: 1=-6.087+ 0.250X2+0.424X6(on state), R2=0.430; 1=-11.459+0.207X2+0.530X6 (off state), R2=0.609. The long-term effect of PVP(2)had relationship with the short-term effect of PVP (X1)and the time of follow-up(X4). The multiple linear regression equations are as follows: 2=2.918+0.802X1+3.927X4 (on state), R2=0.810; 2=4.149+0.743X1+ 4.757X4(off state), R2=0.705.Conclusion ⑴ It appears that PVP can improve and even eliminate the symptom of PD. The short-term effect of PVP is obvious, but the long-term effect of PVP is depressed year after year. During the course of long-term follow-up, However, the symptom of PD in PVP group is better than that in non-PVP group always.⑵ PVP can decelerate the aggravating process of symptom of PD in some degree.⑶ The short-term effect of PVP has relationship with the age at the time of operation and the severity of PD before the operation, whereas the long-term effect of PVP has relationship with the short-term effect of PVP and the time of follow-up.⑷ PVP make its contribute to the improvement of symptom of the patients with PD. Now ,it has become a mature technique to treat the PD and its curative effect is certain.