您的位置:山东大学 -> 科技期刊社 -> 《山东大学学报(医学版)》

山东大学学报(医学版) ›› 2017, Vol. 55 ›› Issue (5): 117-121.doi: 10.6040/j.issn.1671-7554.0.2016.1149

• 经验交流 • 上一篇    下一篇

山东大学齐鲁医院神经外科脑深部电刺激术手术步骤标准化操作流程(SOP)暨核查表

马翔宇,李卫国,陈思,陈腾,李超,徐硕,徐淑军,李新钢   

  1. 齐鲁医院神经外科, 山东 济南 250012
  • 收稿日期:2016-09-12 出版日期:2017-05-10 发布日期:2017-05-10
  • 通讯作者: 徐淑军. E-mail: xu-shujunql@163.com李新钢. E-mail: xgli-sdu@163.com E-mail:xu-shujunql@163.com
  • 基金资助:
    山东省自然科学杰出青年基金(BS2013YY018)

Standard operation procedure and checklist of deep brain stimulation in department of neurosurgery, Qilu Hospital of Shandong University

MA Xiangyu, LI Weiguo, CHEN Si, CHEN Teng, LI Chao, XU Shuo, XU Shujun, LI Xingang   

  1. Department of Neurosurgery, Qilu Hospital of Shandong University, Jinan 250012, Shandong, China
  • Received:2016-09-12 Online:2017-05-10 Published:2017-05-10

摘要: 脑深部电刺激术已经成为治疗中晚期帕金森病外科治疗的金标准,其可以明显地改善PD患者的运动症状,提高生活质量。山东大学齐鲁医院神经外科自2005年开始实施DBS手术,总结DBS手术特点主要有以下几方面:(1) 需要熟练掌握Leksell头架、手术计划系统、微电极记录系统等新型手术设备的应用;(2) 该手术操作对精度要求极高;(3) 手术步骤多,过程较繁琐,任何操作失误都将影响手术效果;(4) 除了一个训练有素的神经外科团队,还需要手术室、神经内科、麻醉科、影像科、信息中心通力配合,且各部门工作都将决定手术进程的推进。鉴于DBS手术的特点,结合国内外学者制定的神经外科手术核查表的经验,提出并初步实践了DBS手术步骤标准化操作流程(SOP)暨核查表。

关键词: 脑深部电刺激术, 标准化操作流程, 核查表, 帕金森病

Abstract: Deep brain stimulation(DBS)has become the gold standard for surgery of middle and late stage Parkinsons disease(PD), which can significantly improve the motor symptoms and improve the quality of life for patients with PD. The Department of Neurosurgery of Qilu Hospital of Shandong University started DBS surgery in 2005 and have accumulated rich experiences. The authors summed up DBS operation characteristics as followed: (1) The surgeons need to have a good mastery of Leksell headstock, operation planning system, microelectrode recording system and so on. (2) The operation requires high precision. (3) The surgery has complicated steps and process so that any misoperation could affect operation outcome. (4) Except for a well-trained neurosurgery team, cooperation from the operation room, departments of neurology, anesthesiology and radiology is essential, and any department involved decides the process of operation. Based on the characteristics of DBS operation, refering to the experience from domestic and foreign scholars, the authors formulated and initially practised the standard operation procedure(SOP)as well as the checklist of deep brain stimulation surgery.

Key words: Parkinsons disease, Deep brain stimulation, Standard operation procedure, Checklist

中图分类号: 

  • R651.1
[1] Joint C, Aziz TZ. Outcome after deep brain stimulation surgery of the subthalamic nucleus for Parkinson disease: do we understand what is important to our patients?[J]. World Neurosurg, 2014, 82(6): 1035-1036.
[2] Jung YJ, Kim HJ, Jeon BS, et al. An 8-year follow-up on the effect of subthalamic nucleus deep brain stimulation on pain in Parkinson disease[J]. JAMA Neurol, 2015, 72(5): 504-510.
[3] Liu Y, Li W, Tan C, et al. Meta-analysis comparing deep brain stimulation of the globus pallidus and subthalamic nucleus to treat advanced Parkinson disease[J]. J Neurosurg, 2014, 121: 709-718.
[4] 张建国. 脑深部电刺激术的现状与未来[J]. 中华神经外科杂志, 2010, 26(5): 385-386.
[5] 中国帕金森病脑深部电刺激疗法专家组. 中国帕金森病脑深部电刺激疗法专家共识[J]. 中华神经科杂志, 2012, 45: 541-543.
[6] 中华医学会神经病学分会帕金森病及运动障碍学组. 中国帕金森病治疗指南(第三版)[J]. 中华神经科杂志, 2014: 428-433.
[7] Connolly PJ, Kilpatrick M, Jaggi JL, et al. Feasibility of an operational standardized checklist for movement disorder surgery. A pilot study[J]. Stereotact Funct Neurosurg, 2009, 87(2): 94-100.
[8] Christian E, Harris B, Wrobel B, et al. Endoscopic endonasal transsphenoidal surgery: implementation of an operative and perioperative checklist[J]. Neurosurg Focus, 2014, 37(4): E1. doi: 10.3171/2014.7.FOCUS14360.
[9] Zuckerman SL, Green CS, Carr KR, et al. Neurosurgical checklists: a review[J]. Neurosurg Focus, 2012, 33(5): E2. doi: 10.3171/2012.9.FOCUS12257.
[10] 马翔宇, 徐淑军, 李新钢. 眶上外侧入路无血快速开关颅技术单中心标准化操作流程[J]. 中华神经外科杂志, 2015, 31(9): 958-960.
[1] 勾云, 周波, 魏操,陈运华, 徐利,刘芬, 张春林, 文敏. 硫辛酸对帕金森病大鼠黑质线粒体的保护作用[J]. 山东大学学报(医学版), 2017, 55(8): 18-23.
[2] 崔萌,郑冀鲁,田思男,李连军,张琦,金讯波,王慕文. 前列腺绿激光汽化术治疗良性前列腺梗阻伴帕金森病的疗效[J]. 山东大学学报(医学版), 2017, 55(7): 100-102.
[3] 张文君,沈遥遥,戴庭敏,柴艺轩,涂江龙. 帕金森病并发喉痉挛1例[J]. 山东大学学报(医学版), 2017, 55(5): 125-126.
[4] 王思,李秀华,杜鹃,岳龙涛,王瑶,刘菲,郭配. 侧脑室注射腺病毒介导的GDNF基因对帕金森病的保护作用[J]. 山东大学学报(医学版), 2016, 54(4): 32-36.
[5] 翟永华,徐淑军,马翔宇,李卫国,王芳,李新钢. 神经外科立体定向手术一次性手术铺巾的设计与应用体会[J]. 山东大学学报(医学版), 2016, 54(10): 90-91.
[6] 杨璐, 周英泽, 倪明, 樊秀双, 满建梅, 郭军堂. β-synuclein对Ⅱ型囊泡单胺转移体表达的促进作用[J]. 山东大学学报(医学版), 2015, 53(4): 61-64.
[7] 陈思, 王牧川, 任楠楠, 许巍, 王玲玲, 栾海辉, 马俊, 刘艺鸣. Parkin基因多态性与山东省汉族帕金森病发病风险的关系[J]. 山东大学学报(医学版), 2015, 53(4): 71-74.
[8] 张忠霞, 马晓伟, 王彦永, 李晓丽, 王铭维. 帕金森病模型小鼠黑质纹状体系统氧化应激的增龄性改变[J]. 山东大学学报(医学版), 2014, 52(9): 26-29.
[9] 张静1,暴丽华1,2,吴金涛1,李贵宝1,刘海莉1,岳庆伟1,朱德晓1,孙东1,宋守阳1,丁兆习1,孙晋浩1. 帕金森病肠功能分析及CXCR4在肠神经系统中的表达[J]. 山东大学学报(医学版), 2014, 52(5): 25-29.
[10] 孟祥继,庞琦,丁锋,辛涛,杨洪安. 纹状体立体定向注射Taclo建立帕金森病大鼠模型[J]. 山东大学学报(医学版), 2014, 52(3): 16-18.
[11] 曹伟,刘威,辛涛,庞琦. 纹状体定向注射TaClo介导的大鼠行为学改变及其黑质中cox-2的表达[J]. 山东大学学报(医学版), 2013, 51(11): 6-9.
[12] 周波1,文敏1,王赟2,龙高群3,瞿廷念3,李宏伟1,焦玲4,张春林3. 依达拉奉对帕金森病小鼠模型中脑细胞自噬的影响[J]. 山东大学学报(医学版), 2012, 50(8): 1-4.
[13] 陈思1,刘艺鸣1,任楠楠1,陈良1,李佳珍3,宁翔2,王京1. 散发性早发帕金森病PARK2基因突变及其临床特征[J]. 山东大学学报(医学版), 2012, 50(7): 55-59.
[14] 李恒1,李晓红2,毕建芬3,陈亚娜4. 全反式维甲酸促人脐血多能干细胞向多巴胺能神经元分化[J]. 山东大学学报(医学版), 2012, 50(6): 92-96.
[15] 李佳珍1,刘艺鸣1,吴林2,相媛媛3,张杨4,陈思1,任楠楠1. 美多芭与安坦对PD大鼠抑郁症状的影响[J]. 山东大学学报(医学版), 2011, 49(11): 30-33.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
No Suggested Reading articles found!