立体定向多靶点毁损术改善顽固性精神分裂症患者的强迫状态和智力水平(英文)

Stereo-orientation multi-target damage technique ameliorates o bsessive state and intellect levels of refratory schizophrenia patients

目的:探讨伴有强迫状态的顽固性精神分裂症的手术方法,及此术式对顽固性精神分裂症的影响。方法:对6例伴有强迫状态的精神分裂症患者,经术前评估后,在全麻下行立体定向双侧杏仁核、双侧内囊前肢和双侧扣带回射频毁损,术后应用BPRS量表(简明精神病评定量表)、Yale-Brown强迫评定量表以及WAIS智力量表进行疗效评定。结果:患者Yale-Brown强迫评定量表平均得分由术前的33分降为17分;WAIS智力量表平均得分由术前84分变为87分;术后随访6个月,6例患者中1例治愈,4例显著好转,1例好转。1例患者术后早期出现一过性尿失禁。结论:CT引导下立体定向多靶点毁损术能改善顽固性精神分裂症强迫状态,并提高患者的智力水平。

AIM: To explore the operative method of refractory schizophrenia accompanied wit h obsessive state and its effect. METHODS: Six refractory schizophrenia patients accompanied with obsessive sta te were evaluated before operation,then bilateral nucleus amygdalae, bilateral anterior limb of internal capsule and bilateral callosal gyrus were damaged with stereo orientation radio- frequency under general anesthesia.After operation,t he effect was evaluated by using BPRS, Yale- Brown compulsion rating scale and WAIS. RESULTS: Average scores of the patients using Yale- Brown compulsion rating scale decreased from preoperative 33 to 17.Average scores of the patients using WAIS increased from preoperative 84 to 87.The patients were followed up for six months.One patient among them was cured,four improved significantly,one improved .Urinary incontinence occurred temporarily during earlier period after operation in one patient. CONCLUSION: Stereo orientation multi- target damage technique guided by CT c ould ameliorate obsessive state and improve intellect levels of refractory schiz ophrenia patients.