多靶点调控手术治疗难治性精神病80例近期疗效观察

Therapeutic Efficacy of 80 Patients with Refractory Psychosis by Stereotactic Neurosurgery

目的:探讨立体定向技术和多靶点组合对难治性精神病的治疗意义,综合评估临床疗效。方法:在立体定向基础上,应用CT、电阻值和微电极电生理进行核团定位,对80例难治性精神病患者,采用杏仁核、内侧隔区、扣带回等多靶点组合射频热凝治疗。应用临床疗效总评量表(clinicalgrobalimpressionsscale,CGl)、简明精神病评定量表(briefpsychiatricratingscale,BPRS)、阴性和阳性综合量表(thepostitveandnegativesyndrome,PNSS)精神病评定量表在术后6个月对治疗效果进行评定。结果:依据减分率标准,80例患者中,显著进步46例,进步31,无变化3例。手术前后量表评分有显著差异(P<0.05)无严重并发症和后遗症发生。结论:多靶点组合的立体定向技术是难治性精神病的有效治疗方法之一,靶点组合设计和亚核团的准确定位,对提高疗效,降低并发症有较大意义。

Objective： To analyze the significance of intractability psychosis in use of mutiple target and Stereotactic surgery. Methods： 80 patients .were treated by stereotactic technique connect with CT, microelectrode and electric impedance methods with bilateral multiple nuclei lesion by radio-frequency thermocoagulafion. The therapeutic effects were estimated with CGI, BPRS and PNSS. Rusults： On the sixth month after operation, there was significant different in measuring scale between preoperative and postoperative（p〈0.05） Base on the code of decreased rate, 46 patients were repectively improved, 31 patients were improved and 3 patient swere invalid, no complication and sequela taken occurrenced. Conclusion： The stereotactic technique with multiple locations was an effective method to treat intractability psychosis. It might be great significance to improve the effect, especially using new mutiple targets and accuracy location of subset nuclei.