多靶点射频毁损术治疗药物难治性抽动秽语综合征的效果分析

Effect of multi-target radiofrequency ablationon patients with drug-refractory Tourette's Syndrome

目的探讨多靶点射频毁损术治疗药物难治性抽动秽语综合征的临床效果。方法回顾性分析2008年1月至2016年12月于本院采用多靶点射频毁损术治疗的12例药物难治性抽动秽语综合征患者的临床资料,术中根据头部MRI扫描定位选择多个毁损靶点;术前、术后采用耶鲁综合抽动严重程度量表(Yale global tic severity scale,YGTSS)评估患者症状改善程度,包括运动抽动评分、发声抽动评分、严重程度总评分及YGTSS减分率。结果 12例患者随访6个月,手术切口均愈合良好。患者术后随访期内运动抽动和发声抽动均明显改善;术后2周、术后6个月,患者YGTSS评分均显著低于术前(P<0.05);患者术后减分率均高于60%,患者均未发生严重并发症。结论多靶点射频毁损术是治疗药物难治性抽动秽语综合征安全、有效的方法。

Objective To investigate the clinical efficacy of multiple-target radiofrequency damage in the treatment of drugrefractory Gilles de la Tourette's syndrome.Method From January 2008 to December 2016,12 patients with Gilles de la Tourette's syndrome were treated with multi-target lesions in our hospital were retrospectively analyzed.During the operation,multiple damage targets were selected by MRI scan of the head.Before and after surgery,Yale syndrome severity scale(YGTSS)was used to assess the degree of symptom improvement in patients,including motor tics,vocal tics,total severity scores,and the reduction rate of YGTSS.Result 12 patients were followed up for 6 months,all of them surgical incision healed well.During the follow-up period,motor twitching and voicing and twitching were all significantly improved.After operation,the YGTSS scores at 2 weeks and 6 months were significantly lower than those before operation(P<0.05).The reduction rate of the patients after operation was higher than 60%.No serious complications occurred in all patients.Conclusion Multiple-target radio frequency ablation is a safe and effective method for the treatment of drug-refractory Gilles de la Tourette's syndrome.