多靶点亚核团毁损治疗难治性精神分裂症1232例

Lesion of Subnuclear Multi-Targets with Radiofrequency for Intractable Schizophrenia (a Report of 1 232 Cases)

目的探讨双侧多靶点亚核团毁损手术治疗难治性精神分裂症的疗效和安全性。方法采用螺旋CT定位,对1232例难治性精神分裂症患者,实施立体定向同期双侧多靶点亚核团射频热凝毁损手术。结果1232例患者术后2周随访:显著进步428例,进步722例,无效81例,无加重病例,死亡1例(术后3d死于急性肺动脉栓塞),有效率93.34%;1134例术后远期(6～54个月)随访:恢复204例,显著进步424例,进步410例,无效96例,无加重病例,有效率91.53%;术后除早期一过性并发症外,远期并发症发生率小于1%。结论多靶点亚核团毁损手术治疗难治性精神分裂症疗效显著,安全性高;对阳性、阴性症状均有效果,亚核团毁损既保留了正常的脑功能,又控制了精神症状。

Objective To explore the curative effect of the lesion of bilateral subnuclear muhi-targets on intractable schizophrenia and its complications. Method The bilateral subnuclear multi-targets were stereotactically destroyed at the same stage with radiofrequency in 1 232 patients with intractable schizophrenia. Results Of the 1 232 patients, 428 were significantly improved in the clinical symptoms, 722 improved and 82 unchanged 2 weeks after the operation, and the total effective rate was 93.34%. Of 1 134 patients who were followed up from 6 to 54 months, 204 were recovered well, 424 significantly improved in the clinical symptoms, 410 improved and 96 unchanged, and the total rate was 91.53%. Except the temporal complication early after the stereotactic operation, occurent rate of the long-term complication was lower than 1%. Conclusion The lesion of subnuclear multi-targets, which is a safe and effective method to treat intractable schizophrenia, can not only control the symptoms, but also not do damage to the normal brain function in the patients with intractable schizophrnia.