双侧伏隔核立体定向射频毁损或DBS治疗海洛因精神依赖

Neurosurgical treatment on alleviating heroin psychological dependence

目的探讨外科手术治疗戒除海洛因药物成瘾所致精神依赖的有效性。方法通过立体定向手术,对27例药物成瘾患者的双侧伏隔核进行射频毁损,1例患者双侧伏隔核行脑深部电刺激仪(DBS)植入术。结果所有患者平均随访8个月,失随访2例,总随访数26例,其中优效者18例(69.2%),良好者4例(15.3%),一般者2例(7.7%),差效者2例(7.7%)。结论立体定向引导下行双侧扣带回和(或)伏隔核射频热凝毁损或高频电刺激,戒除海洛因药物成瘾所致精神依赖是一种有效、可行的方法。

Objective To explore the effect of alleviating the psychological dependence on heroin by ablating the nucleus accumbens （NAc） . Methods 28 cases suffered from drug addiction. 27 of all patients underwent stereotactic surgery by ablating the NAc bilaterally, one patient underwent bilateral deep brain stimulation （DBS） in NAc. Results All of the patients were followed up with a mean of 8 months, the information of 2 cases were lost, 18 patients had an excellent results, 2 patients had a good results, the drug-free time were more than half a year; relapse occurred in 2 cases, the drug free time was between 3 months and half a year in 2 cases and less than a month in 2 cases. No particular complications occurred. Conclusions The operation on alleviating drug addicts＇ psychological dependence by ablating the NAc bilaterally or deep brain stimulation （DBS） on bilateral NAc is feasible and safe.