多靶点联合毁损治疗难治性强迫症31例

Clinical analysis of Leksell C gamma knife radiosurgery for multi-target lesioning to 31 patients with refractory obsessive complusive disorder

目的探讨Leksell C型伽玛刀多靶点联合毁损治疗难治性强迫症的临床治疗效果。方法对31例难治性强迫症应用美国GE1.5T MRI定位,1.4 mm无间距扫描,Leksell C型伽玛刀对双侧内囊前肢和右侧扣带回进行毁损治疗。术前及术后应用Yale-Brown强迫症状量表、汉密尔顿抑郁量表以及汉密尔顿焦虑量表对治疗效果进行评价。结果术后随访6～36个月。其中13例出现一过性并发症,均在1～2周内恢复。患者术后强迫、焦虑、抑郁量表分数明显下降(P<0.01)。结论Leksell C型伽玛刀多靶点联合毁损是目前治疗难治性强迫症的一种安全有效方法,其并发症轻,可显著改善患者的强迫、焦虑、抑郁症状。

Objective To assess the clinical effect of Leksell C gamma knife for multi-target lesioning to refractory obsessive complusive disorder.Methods 31 patients with refractory obsessive complusive disorder were orientated by GE 1.5T MRI,1.4 mm scan without interval and treated by Lekcell C gamma knife.Pre-and post-operative Yale-Brown obsessive-complusive rating scale,Hamilton depression rating scale and Hamilton anxiety rating scale were used by psychiatrists for evaluating the effect.Results At follow-up of 6-36 months after treatment,there were mild post-treatment complication in 13 cases,and all recovered within 1-2 weeks.Psychiatric evaluations by the rating scale demonstrated that there were significantly decreases in above rating scale for anxiety,compulsion and depressive symptoms（P〈0.01）.Conclusion Treatment with multi-taget lesioning for refractory obsessive complusive disorder with Leksell C gamma knife is effective and safe methods.It can reduce anxiety,compulsion and depressive symptoms significantly.