Objective: To analyze the complications related to deep brain stimulation(DBS) surgery in Parkinson's disease(PD) patients and to determine whether there is a learning curve effect in terms of complications. Methods: Retrospective analysis of the DBS surgical data of 822 PD patients performed by the same surgeon at the First Affiliated Hospital of the University of Science and Technology of China (Anhui Provincial Hospital) from December 2012 to December 2022. The complications related to DBS were evaluated and analyzed the complications of every 100 DBS surgery were further analyzed. Results: A total of 822 PD patients, 453 males and 369 females, aged 31-80 years old, were included. The minimum follow-up period after DBS surgery is 6 months. Surgical related complications occurred in 55 patients (6.69%), including 5 patients (0.61%) with slight bleeding around the electrode, 1 patient (0.12%) with cerebral infarction, 4 patients (0.49%) with postoperative epilepsy, 42 patients (5.11%) with postoperative delirium, 2 patients (0.24%) with respiratory distress, and 1 patient (0.12%) with acute cardiac insufficiency. There were 16 cases (1.94%) of hardware related complications in DBS, of which 4 cases (0.48%) had infection, 1 case (0.12%) had a broken angle at the connection between the pulse generator and the extension wire, 8 cases (0.97%) had an excessively tight extension wire, and 3 cases (0.36%) had an IPG bag hematoma. In the infected cases, 2 patients removed IPG and extension wires. There were 7 cases (0.85%) of stimulus related complications, including 4 cases (0.61%) with programmed sensory abnormalities, 1 case (0.12%) with postoperative abnormal movements and dance like movements, and 2 cases (0.24%) with psychiatric symptoms. A comprehensive analysis was conducted on the above complications, among which 8 cases (0.97%) were relatively serious complications. After active treatment, satisfactory results were achieved, and none of them affected the patient's DBS treatment effect and no patients died. For every 100 cases of DBS surgery complications were analyzed, the percentage of complications decreased significantly from 14.50% (58 cases) in the first 400 cases to 4.73% (20 cases) in the last 400 cases (P<0.001). Conclusion: DBS surgery is safe and has an acceptable low incidence of complications. The incidence of complications also decreases with the accumulation of experience, showing a learning curve effect.
目的： 分析帕金森病（PD）患者脑深部电刺激（DBS）手术相关并发症，并探讨在并发症方面是否存在学习曲线效应。 方法： 回顾性分析中国科学技术大学附属第一医院（安徽省立医院）2012年12月至2022年12月间由同一术者进行的822例PD患者DBS手术资料。评估DBS相关并发症，并对每100例DBS手术的并发症进行分析。 结果： 822例PD患者，男453例，女369例，年龄31~80（62±7）岁。DBS手术后，最短随访期为6个月。手术相关的并发症为55例（6.69%），其中5例（0.61%）患者出现电极周围少许出血，1例（0.12%）患者出现脑梗死，4例（0.49%）患者术后出现癫痫症状，42例（5.11%）患者术后出现谵妄症状，2例（0.24%）患者发生呼吸窘迫，1例（0.12%）患者急性心功能不全。DBS硬件相关的并发症16例（1.94%），其中4例（0.48%）出现感染，1例（0.12%）出现脉冲发生器与延伸导线连接处折角断裂，8例（0.97%）出现延伸导线过紧，3例（0.36%）出现脉冲发生器（IPG）囊袋血肿。在感染病例中，2例患者移除了IPG和延伸导线。刺激相关的并发症7例（0.85%），其中4例（0.61%）程控出现感觉异常，1例（0.12%）术后出现异动及舞蹈样动作，2例（0.24%）出现精神症状。对上述并发症进行综合分析，其中属于较严重并发症8例（0.97%），经积极处理，获得满意效果，均未影响患者DBS治疗效果。无死亡患者。对每100例DBS手术的并发症进行分析，并发症的百分比从前400例的14.50%（58例）下降到后400例的4.73%（20例）（P<0.001）。 结论： DBS手术是安全的，并发症发生率低。并发症发生率也随着经验的积累而降低，表现出学习曲线效应。.