立体定向毁损伏隔核为主治疗精神疾病41例

Stereotactic Nucleus Accumbens Lesion-based Treatment of Mental Illness

目的观察立体定向手术方法毁损伏隔核为主治疗精神疾病的疗效。方法对30例药物依赖、7例难治性精神分裂、3例难治性癫痫合并精神障碍、1例酒精依赖的患者行立体定向手术毁损伏隔核为主,配合毁损扣带回、杏仁核、Forel-H区,观察其疗效。结果41例患者均符合手术疗效标准出院。术后经1～22个月的随访,药物依赖患者中6例复吸,精神分裂病人中1例强迫症发作住院治疗1次,癫痫病人术后发作明显减少,疗效尚满意。结论伏隔核可能是治疗精神疾病的有效靶点,立体定向手术毁损伏隔核为主治疗精神疾病效果肯定,相对安全。

Objective To study the stereotactic nucleus accumbens lesion-based treatment of 41 cases of mental illness. Methods There were 4t patients with mental illness,including 30 patients with drug dependence,7 with refractory schizophrenia,3 with refractory epilepsy and one with alcohol addiction. All the patients were treated with the stereotactic nucleus accumbens lesion-based technique combined with cingu- late gyms lesion,amygdala lesion and Forel-H area lesion. Results All the 41 patients were improved and no significant postoperative neu- rological complications were observed. During a follow-up period of l to 22 months, 6 patients relapsed in 30 patients with drug dependence, and one had onset of obsessive- compulsive disorder in 7 patients with schizophrenia. Conclusion Nucleus accumbens may be an effective target for treatment of mental illness and the stereotactic nucleus accumbens lesion-based treatment of mental illness is effective and safe.