立体定向不同靶点组合治疗难治性精神病

The clinical analysis of intractable psychosis with stereotactic techniques:report of 138 cases

目的 探讨立体定向技术和多靶点组合对难治性精神病的治疗意义。方法 在立体定向基础上 ,应用CT、MRI、电阻值和微电极电生理进行核团定位 ,对 1 2 8例难治性精神病患者 ,采用杏仁核、内侧隔区、扣带回等多靶点组合射频热凝治疗。应用临床总体印象量表 (clinicalgrobalimpressionsscale ,CGI)、简明精神病评定量表(briefpsychiatricratingscale ,BPRS)、阴性和阳性综合量表 (thepostitveandnegativesyndrome ,PNSS)精神病评定量表对治疗效果进行评定。结果 依据减分率标准 ,1 2 8例患者中 ,显著进步 73例 ,进步 5 1例 ,无变化 4例。手术前后量表评分有显著差异 (P <0 .0 5 )。无严重并发症和后遗症发生。结论 多靶点组合的立体定向技术是难治性精神病的有效治疗方法之一 ,靶点组合设计和亚核团的准确定位 ,对提高疗效。

Objective To study the significance of intractability psychosis in use of mutiple target and Stereotactic surgery.Methods 128 patients were treated by stereotactic technique connect with CT、MRI、 microelectrode and electric impedance methods with bilateral multiple nuclei lesion by radio-frequency thermocoagulation.The therapeutic effects were estimated with CGI、BPRS and PNSS.Results there are significance different in measuring scale between preoperative and postoperative ( P <0.05).Base on the code of decreased rate,73 patients were respectively improved, 51 patients were improved and 4 patientswere invalid,no complication and sequela taken occurrenced.Conclusion The stereotactic technique with multiple locations is an effective method to treat intractability psychosis.It is a great significance to improve the effect,especially using new mutiple targets and accuracy location of subset nuclei.