Analysis Of Curative Effect Of Stereotactic Brain Nucleus Lesion In The Treatment Of Early-onset And Late-onset Parkinson's Disease

ObjectiveComparative analysis of stereotactic brain nucleus lesion surgery treatment of early-onset and late-onset Parkinson's disease and to explore its clinical value and significance.Materials and MethodsRetrospective analysis of the Second Affiliated Hospital of Zhengzhou University Neurosurgery January 2013 to October 2016 underwent stereotactic unilateral brain nucleus lesion treatment of 206 patients with PD clinical data,According to the age of onset ? 50 years for the boundaries,which was divided into early-onset group and late-onset group;Early-onset group of 79 cases,there were 45 males and 34 females,age between 35 and 63 years old,the mean age of onset(52.67 ± 6.29)years,the disease duration was 3.5 to 17.2 years,the mean course of disease(7.41 ± 2.91)years;Preoperative dopamine administration with dyskinesia 24 cases,without dyskinesia 55 cases;Vim nucleus lesion 28 cases,GPi nucleus lesion 51 cases;Late onset group of 127 cases,there were 78 males and 49 females,age between 58 and 79 years old,the mean age of onset(66.49 ± 5.02)years,the disease duration was 4.3 to 24.2 years,the mean duration was(7.30 ± 3.06)years;Preoperative dopamine administration with dyskinesia 32 cases,without dyskinesia 95 cases;Vim nucleus lesion 92 cases,GPi nucleus lesion 35 cases;preoperative according to revised Hoehn-Yahr grade:1.5 grade 12 cases(5.8%),2 grade 42 cases(20.4%),2.5 grade 45 cases(21.8%),3 grade 91 cases(44.2%),4 grade 16 cases(7.8%).Preoperative,postoperative 1 week,3 months by clinical observation and follow-up record Hoehn-Yahr grade,UPDRS score,the patient's daily living ability was assessed using the UPDRS scale II,exercise capacity using UPDRS scale III,comparison between the two groups using UPDRSII + III results,data were collected using SPSS21.0 statistical software,p <0.05 was statistically significant.ResultsThe main symptoms of the two groups,the duration of the course of disease comparison(p <0.05),statistically significant,suggesting that the two groups of symptoms and duration of the disease are different;respectively,two groups of patients after operation 1 week,3 months of single factor analysis of variance(p <0.05).There was statistically significant.suggesting brain nucleus lesion in the improvement of the two PD significant effect;An independent sample t test was performed on the UPDRSII + III score between the two groups,at 1 week after operation(p> 0.05),there was no statistical significance,suggesting that early-onset group and late-onset group of recent(1 week after surgery)the effect of considerable,3 months after surgery(p <0.05),statistically significant,suggesting that early-onset group(3 months after surgery)is better than late-onset group on efficacy;Lesion in two groups of patients on postoperative about the dyskinesia improvement underwent ?2 test(p <0.05),there was statistically significant,suggesting that the improvement of postoperative brain nucleus lesion surgery in the medication caused dyskinesia aspect,early-onset group improved better than late-onset group;The improvement of the main symptoms in the two groups was performed by ?2 test(p <0.05),which indicated that there were significant differences in the improvement of tremor and stiffness between the two groups;Two groups of patients complications executed R × C column row ? 2 test,1 week after surgery,cerebral hemorrhage,seizures(p <0.05),statistically significant,Postoperative 3 months appeared in the limb weakness,sensory disturbances,visual flash and other complications(p> 0.05),suggesting that early-onset group of postoperative lesion site hemorrhage,seizures complications were lower than the late-onset group,as for the long-term complications,the two groups were not significantly different.ConclusionStereotactic brain nucleus lesion surgery treatment of early-onset and late-onset PD were efficacy significant,and early-onset lesions in patients with long-term efficacy is better than late-onset,brain nucleus lesion surgery in treatment early-onset with dyskinesia aspect improved better than late-onset;The effect of the lesion on the improvement of the stiffness of the early-onset type is better than that of the late-onset type,and the improvement of the tremor symptom in the late-onset type is superior to that of the early-onset;Postoperative recent lesion site hemorrhage,seizures complications early-onset lower than late-onset,for the long-term complications,the two types of PD have not yet found the difference.