近年来，脑深部电刺激技术在国内外逐渐发展成熟，国产脑起搏器产业崛起，其治疗运动障碍性疾病的安全性和有效性得到公认。脑深部电刺激疗法现已成为治疗神经外科功能性疾病的重要手段之一。而术前评估作为判断帕金森病患者是否适合进行手术治疗的最重要一环，目前依然主要依靠医生经验进行判断，在诊断准确度、效率和术前数据保存等方面都存在一定问题。论文以脑深部电刺激疗法在治疗帕金森病方面的应用为背景，基于临床试验数据，重点探讨术前评估体系的定量分析和术后效果预测，提出定量化打分评估的思想，为帕金森病患者信息的存储、评估和预测提供更为方便的平台。论文首先调研和总结了脑深部电刺激术前评估的经典理论及体系，主要介绍CAPSIT-PD神经外科手术术前评估体系，总结针对帕金森病的脑深部电刺激手术的核心入选标准以及评估过程的核心方法论。其次，根据临床实际需求，提出定量化评估的思想。针对中国帕金森病人的情况进行总结，提炼出术前评估的评分要点。同时在第二章CAPSIT-PD评估体系和核心标准的基础之上，结合国外和国内术前评估的要点和方法，参考医生经验，分临床诊断、运动评估、行为认知和并发症四个部分撰写脑深部电刺激术前定量评估细则，实现了术前评估的定量化。接下来，建立术前评估模型，并运用matlab软件进行模型参数拟合。根据患者术前评估各项结果，直接得出术前评估综合得分，反映病人术后效果。同时针对本课题所涉及的临床情况，运用专业分析软件，对影响术后效果的因素进行logistic回归分析和ROC分析。研究运动评估和并发症这两大因素对术后效果的影响比重大小。最后，在以上工作的基础上，以临床实际为依据，设计了基于PHP脚本开发语言、MySQL数据库、Apache服务器的帕金森患者信息数据库。使用户可以方便地使用 Web 浏览器通过 Internet 访问数据库，对患者资料进行科学化的管理，并进一步完成手术效果预测功能，为患者是否适合进行脑深部电刺激疗法提供数据参考。
In recent years, deep brain stimulation technologies at home and abroad have been gradually mature, and with the rise of domestic brain pacemaker industry, its safety and efficacy in the treatment of motility diseases have been recognized. Deep brain stimulation therapy has become one of the most important means of treatment of functional neurosurgery disease. While preoperative assessment plays an important role in the judgement whether Parkinson's patients are suitable for surgical treatment, doctor still rely mainly on experience judgement, and there exist certain problems in such aspects as the diagnosis of accuracy, efficiency, and preoperative data storage.The paper is based on deep brain electrical stimulation therapy’s application in the treatment of Parkinson's disease and clinical trial data, mainly discusses the quantitative analysis of the preoperative assessment system and performance forecast, puts forward the thought of the quantitative grade assessment, and provides more convenient platform for Parkinson's patients information storage, assessment and prediction.The paper first researches and summarizes the classic theory and system of deep brain stimulation preoperative evaluation , mainly introduces CAPSIT-PD neurosurgery preoperative evaluation system, summarizes the core inclusion criteria of the deep brain electrical stimulation for Parkinson's disease surgery and methodology for assessment.Secondly, according to the clinical demand, the paper puts forward the idea of quantitative evaluation. After the summarization of Parkinson's patients s in China, the paper extracts key score points for preoperative assessment.At the same time, based on CAPSIT-PD assessment system and on the core standard in the second chapter, combined with foreign and domestic preoperative evaluation and methods, the paper writes deep brain stimulation preoperative quantitative evaluation rules with reference of doctors experience, clinical diagnosis, assessment, cognitive behavioral movement and complications, and implements the quantification of preoperative evaluation.Next, preoperative evaluation model is set up, and fitting method for model parameters is designed using matlab software. According to of the patient’s preoperative assessment results, the composite scores are directly obtained, which reflect the patients’ postoperative effect. At the same time, based on the clinical situation in this topic, using professional analysis software, the paper performs logistic regression analysis and ROC analysis on the influencing factor of postoperative effect, and studies the weight of the two factors’ (motion evaluation and complications) effect on postoperative performance.Finally, on the basis of the above work, based on clinical practice, the paper designs Parkinson's patients information database on the ground of PHP script development language, MySQL database and the Apache server.Users can easily use a Web browser over the Internet to access the database, to carry on scientific management of the patient data, and to further complete the surgery effect prediction, which provides data reference for deciding whether deep brain stimulation therapy is appropriate for patients.
