MRI定向下核团毁损术治疗难治性精神分裂症

Clinical effect of MRI guided stereotactic radiofrequency lesion in patients with intractable schizophrenia

目的应用MRI定向下核团毁损术治疗难治性精神分裂症，并对其疗效及并发症进行评估。方法采用MRI定向下脑内单靶点或组合靶点射频毁损术治疗38例难治性精神分裂症，术后6月依据全国精神外科协作组1990年标准对疗效进行评价。手术前后应用简明精神量表BPRS及各因子分评价手术效果。结果38例患者术后6月恢复8例。显著进步15例。进步12例，无效3例，加重0例，有效率92．1％；15例次术后出现早期一过性并发症，均在术后2周内恢复。术后简明精神量表BPRS总分及焦虑忧郁、缺乏活力、思维障碍、激活性、敌对猜疑等因子分均明显下降，术前、术后有显著性差异（P〈0．05）。结论MRI定位下核团毁损术治疗难治性精神分裂症效果显著，精确，安全。

Objective To study the clinical effect and complications of MRI guided stereotactic radiofi＇equency lesion in patients with intractable schizophrenia, Methods Thirty-eight cases of intractable schizophrenia underwent MRI guided stereotactic stereotactic radiofi＇equency lesion for single target or combined target. According to 1990 standards fi＇om National Psychosurgery Cooperation, the therapeutic outcome was assessed 6 months after operation. In addition, pre- and post-operative brief psychialric reacting scale （BPRS） scores were got by psychiatrists for evaluating the curative effect. Results Six months after operation, 8 cases were flee fi＇om symptoms, 15 cases were significantly improved, 12 improved a little and 3 had no improvement. The effective rate was 92.1%. 15 cases had mild transient post-operative complications, and all recovered within 2 weeks. Psychiatric evaluations of BPRS demonstrated that there were significant decreases in total score and factor scores of anxiety-depression, lacking-activity, disturbance, activation and hostile-suspiciousness after operation （P〈0.05）. Conclusions MRI guided stereotactic radiofi-equsency lesion is accurate, safe and effective for intractable schizophrenia.