立体定向手术治疗难治性抽动-秽语综合征的效果观察

Stereotactic Surgical Treatment for Intractable Tourette's Syndrome

目的探讨立体定向脑内核团毁损术治疗难治性抽动-秽语综合征的疗效和安全性。方法选取我科1999年12月—2004年2月收治的27例难治性抽动-秽语综合征患者,应用MRI和立体定向技术,选择性射频毁损内囊前肢、丘脑、扣带回靶点。采用耶鲁综合抽动严重程度量表(YGTSS)分别于术前、术后1周、术后6个月进行疗效评估。结果患者术后1周、术后6个月的运动抽动评分、发声抽动评分、总体损害程度评分及综合抽动严重程度评分与术前比较,差异均有统计学意义(P<0.01)。无严重并发症发生。结论立体定向脑内核团毁损术是治疗难治性抽动-秽语综合征安全有效的方法之一。

Objective To evaluate the efficacy and safety of treatment for intractable Tourette＇s syndrome with stereotactic nucleus lesion. Methods Totally 27 inpatients with intractable Tourette＇s syndrome, in our department from December 1999 to February 2004, underwent selective radio - frequency ablation on the targets of anterior crus of internal capsule, thalamus and cingulated gyrus by applying Magnet Resonance Imaging and stereotactic technique. All the therapeutic effects were estimated with Yale Global Tic Severity Scale （YGTSS） pre - operation, one week after operation, and 6 months after operation. Results The patients＇ scores of motor tics, phonic tics, overall impairment rating and global severity in YGTSS one week and 6 months after operation were significantly decreased as compared with those pre - operatively （ P 〈 0.01 ）. And no severe complication was found. Conclusion Nucleus lesion with stereotactic technique is one of the effective methods to treat intractable Tourette＇s syndrome.