颅脑手术戒毒后动机形成障碍的原因分析

Pathogenesis Analysis of Motivation-forming Dysfunction after Mini-invasive Operation for Drug Abstinence

通过回顾性研究以往行颅脑手术进行戒毒治疗的病例资料,进而分析双侧伏核射频毁损术后吸毒患者动机形成障碍的原因。我们发现,272例患者中有16例存在术后反馈动机形成障碍,表现为:注意力下降10例,主动性下降7例,交流减少6例,兴趣减少3例,12例多种障碍类型并存。3例伴有其他并发症者症状较轻。4例术后CT或MRI结果提示平均毁损灶体积约12mm×10mm×7mm。3个月以上的心理行为治疗可减轻障碍程度。通过分析,我们认为该类并发症与毁损灶的部位过深、体积过大、反复用药后奖赏阈升高有关,通过靶点精确定位、毁损体积控制可能达到收益和风险的平衡。

We analyzed the reasons for motivation- forming dysfunction in the patients after ablating the nucleus aeeumbens bilaterally by stereotactic surgery, and the results showed that the motivation- forming dysfunction were found in 16 out of 272 eases. We believe that this kind of complication was associated with the immoderate depth and volume of the lesion focus and the elevation of reward threshold after repeated exposure to drugs. The balance of benefit/cost could be obtained through locating the target pre- cisely and controlling the lesion volume.