Ultragarsas vietoj chirurginių intervencijų gydant nekontroliuojamą tremorą?

Ultragarsas vietoj chirurginių intervencijų gydant nekontroliuojamą tremorą?

Netolimoje ateityje pacientai, kenčiantys nuo nekontroliuojamo (esencialinio) tremoro, gali būti gydomi taikant neinvazines ultragarsines procedūras.

Esencialinis tremoras – tai neurologinė patologija, pasireiškianti nevalingais rankų ar kojų judesiais. Kai kuriais atvejais pacientus vargina ir trūkčiojantis balsas. Nors atlikta nemažai tyrimų, iki šio nėra žinomos tikslios esencialinį tremorą sukeliančios priežastys. Jei tremoras yra labai ryškus, gali iškilti sunkumų valgant, rašant, atliekant įprastus kasdienius darbu. Apskaičiuota, kad vien Jungtinėse Amerikos Valstijose įvairaus intensyvumo esencialinis tremoras vargina apie 7 mln. suaugusiųjų.

Įprastai esencialiniam tremorui gydyti skiriami vaistai – propranololis ar primidonas – padeda tik apie 60 proc. atvejų. Tais atvejais, kai minėti medikamentai yra neefektyvūs, pacientui galima pasiūlyti tik chirurgines intervencijas, pavyzdžiui, giliųjų smegenų struktūrų stimuliaciją. Neseniai atliktame tyrime nustatyta, kad kai kuriais atvejais padėti gali neinvazinė ultragarsinė nugaros smegenų stimuliacija (ultragarsinė taliamotomija).

Mokslininkai iš Jungtinių Amerikos Valstijų į neseniai atliktą tyrimą įtraukė 76 pacientus, kuriuos vargino vidutinio sunkumo ar sunkus esencialinis tremoras, o iki tol taikyti medikamentai buvo nelabai efektyvūs. Daliai tiriamųjų buvo atliekamos ultragarsinės galvos smegenų stimuliacijos, daliai – tik tokios procedūros imitacija (placebas). Tiriamiesiems liepta pildyti klausimynus apie savijautą, gyvenimo kokybę. Rezultatai atskleidė, kad, praėjus 3 mėnesiams nuo ultragarsinių galvos smegenis stimuliuojančių procedūrų taikymo pradžios, pacientų savijauta reikšmingai pagerėjo, sumažėjo tiek rankų, tiek kojų tremoras, pagerėjo kalba. Vis dėlto procedūra turėjo ir šiek tiek nepageidaujamo poveikio reiškinių – vaikščiojimo problemų iškilo 36 proc. pacientų praėjus 3 mėnesių nuo gydymo pradžios ir 9 proc. pacientų, praėjus metams nuo gydymo pradžios. Rankų ir veido aptirpimas nustatytas atitinkamai 38 ir 14 proc. pacientų praėjus 3 mėnesiams ir metams nuo gydymo ultragarsu pradžios.

Tyrėjų nuomone, atlikus daugiau efektyvumo ir saugumo tyrimų, tikėtina, kad ultragarsinės galvos smegenis stimuliuojančios procedūros bus patvirtintos esencialinio tremoro gydymui.

Parengta pagal http://www.medicinenet.com/script/main/art.asp?articlekey=197889


143 mintys apie “Ultragarsas vietoj chirurginių intervencijų gydant nekontroliuojamą tremorą?

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