立体定向多靶点联合毁损治疗癫性精神障碍

Stereotactic multi-target lesioning for the treatment of epileptic psychosis

目的总结立体定向多靶点联合毁损治疗癫性精神障碍的疗效。方法回顾分析70例癫性精神障碍病人的临床资料,所有病人均行局部麻醉下立体定向Forel-H区、杏仁核、内囊前肢、胼胝体、扣带回联合毁损术。结果本组无手术并发症和死亡病例。手术疗效满意38例,显著改善19例,良好5例,较差8例;总有效率为88.6%。精神症状疗效达Ⅰ级18例,Ⅱ级32例,Ⅲ级17例,Ⅳ级3例;总有效率95.7%。结论 Forel-H区、杏仁核、内囊前肢、胼胝体、扣带回联合毁损治疗癫性精神障碍是一种安全、有效、微创的治疗方法,值得临床推广和应用。

Objective To summarize the therapeutic efficacy of stereotactic multi-target lesioning for the treatment of epileptic psychosis.Methods Clinical data of 70 patients with epileptic psychosis were analyzed retrospectively.All the patients were treated by stereotactic multi-target lesioning including Forel-H zone,the amygdalas,anterior limb of the internal capsule,callus and cingulate gyrus.Results There was no operative complication and dead case in the study.The surgical outcome was satisfactory in 38 patients,good in 5 and worse in 8,and significant improvement occurred in 19.The overall response rate was 88.6%.The therapeutic effects of the mental symptom： grade Ⅰ was received in 18 patients,grade Ⅱ in 32,grade Ⅲ in 17 and grade Ⅳ in 3,and the overall response rate was 95.7%.Conclusions Stereotactic multi-target lesion including Forel-H zone,amygdalas,anterior limb of internal capsule,callus and cingulate gyrus is a safe,effective and minimally invasive method for patients with epileptic psychosis and worthy of wider clinical application.