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帕金森不只是“抖”那么简单 并发症威胁大
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Topic: 帕金森不只是“抖”那么简单 并发症威胁大 (Read 145 times)
Lindafgdf
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帕金森不只是“抖”那么简单 并发症威胁大
May 02, 2017, 02:52:17 PM
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4月11日是世界帕金森病日。今年适逢世界帕金森病被发现200年,也是中国帕金森病诊疗的第40年。对于这一继肿瘤、心脑血管病之后的中老年人“第三杀手”,公众对它的了解还非常低,甚至还有相当一部分公众将帕金森病与物理学家霍金所患的“渐冻症”画等号。
帕金森病本身不致命 并发症威胁大
“200年过去了,大众对帕金森病的认知程度仍然有限甚至存在误区,这让我感到很痛心”,解放军总医院(301医院)老年神经科主任王振福教授表示,这让他觉得专科医生对帕金森病的知识普及依然任重而道远。
据了解,帕金森病在中国的发病率为1.7%,中国有超过300万帕金森病人。王振福教授介绍,帕金森病是由于大脑黑质多巴胺能神经元的变性死亡,由此而引起大脑分泌的多巴胺物质减少而导致。多见于中老年人,年龄越大,患病的风险越高。迄今为止,病因仍不清楚。
帕金森病的主要症状表现为静止性震颤,就是平常所见的手抖;肌肉僵直,帕金森病患者的肢体和躯体通常变得很僵硬,初期感到某一肢体运动不灵活,有僵硬感,并逐渐加重;运动迟缓,甚至做一些日常生活的动作都有困难,如解系鞋带、扣纽扣等动作变得比以前缓慢许多,或者根本不能顺利完成;除此之外,字越写越小的“小写症”、“面具脸”也是其主要症状表现之一。
尽管帕金森病本身不致命,一般不影响寿命,但是,若没能得到及时合理的治疗,很容易导致身体机能下降,甚至生活不能自理而致残,最后出现如肺炎、泌尿系统感染等可能会威胁到生命的并发症。
王振福教授说,目前仍没有根治帕金森病的方法,但通过采取内科药物、外科手术及其他辅助康复相结合的治疗方法,可以大大缓解症状,让患者能够独立生活,且保持较好的生活质量。
药物与手术结合 可明显改善患者生活质量
从目前对帕金森病的临床治疗经验来看,一旦病情被诊断,首选应该是药物治疗,以此补充患者体内缺乏的多巴胺物质,患者需要终身服药。一般情况下,病情初期依靠药物可以得到较好的控制。然而,据首都医科大学宣武医院功能神经外科副主任胡永生教授介绍,当帕金森病进展到四年左右,药物疗效会下降,药物副作用也会显现,出现异动症和开关现象,比如病人服药后出现肢体不受控制的扭动,形如舞蹈,或者患者因长期服药,症状如同有一个看不见的开关在操纵,常有突然全身僵硬、不自主运动甚至寸步难行的状况发生。
胡永生教授表示,当帕金森疾病进展到严重影响生活质量,可考虑脑起搏器的治疗,脑起搏器可以明显地改善帕金森病患者所产生的动作迟缓、肌肉僵直及(或)震颤的症状,也可明显降低服用药物所产生的副作用。
脑起搏器即脑深部电刺激,通过植入大脑中的细微电极发射电脉冲刺激脑内核团,进而达到控制患者症状的目的,是帕金森病外科治疗领域里程碑式的新技术。目前已在临床使用超过30年,许多研究报告也证明其疗效显著,手术后大多数患者的服药量可明显减少,且活动能力显著提高。宣武医院是国内最早开展脑起搏器手术的医院之一,积累了近20年的手术经验,目前为全球最大的脑起搏器植入中心。北京晨报记者 孔瑶瑶
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帕金森不只是“抖”那么简单 并发症威胁大
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