立体定向同期多靶点毁损治疗难治性精神分裂症的疗效分析

Unstaged bilateral multi-targets radiofrequency lesion in the treatment of intractable schizophrenia

目的探讨立体定向同期双侧多靶点射频毁损治疗难治性精神分裂症的疗效和并发症。方法采用颅脑MR与CT图像融合定位,对342例难治性精神分裂症患者双侧杏仁核、内囊前肢、隔区、扣带回等多靶点同期射频毁损治疗。结果本组342例患者术后2周疗效评定,显著进步74例,进步256例,无效9例,有效率96.49%。术后3例病人出现颅内出血,2例恢复良好,1例重残。随访1年以上:恢复21例,显著进步159例,进步147例,无效12例,有效率95.61%(3例出血病人未列入)。结论立体定向脑内核团毁损治疗难治性精神分裂症安全、有效,能明显改善患者生活质量。

Objective To explore the effect and complications of unstaged bilateral multi-- targets radiofrequency lesion in the treatment of intractable schizophrenia. Methods 342 cases with intractable schizophrenia were treated by MR and CT guided stereotactic multi--target lesion of bilateral amygdala, the internal capsule forelimb, septal area and cingulate gyrus. Results After 2 weeks of operation to 342 cases, 74 were obviously improved, 256 were improved and 9 were no change, efficiency ratio was 96.49 % The complication includes 3 cases of secondary hemorrhage,2 patients well recovered and 1 severely disabled. After 12 months of operation to 342 cases, 21 were recovered, 159 were obviously improved, 147 were improved and12 were no change, efficiency ratio was 95. 61%. Conclusion The present study suggests that the stereotactic surgery is safety and effective, can improve the patients quality of life.