立体定向同期多靶点手术治疗难治性精神分裂症392例

目的 探讨螺旋CT引导下同期双侧多靶点手术治疗难治性精神分裂症的疗效和并发症。方法 采用螺旋CT直接定位和按坐标定位相结合方法计算靶点坐标值，术中用微电极进行电生理测定，记录阻抗值，对392例难治性精神分裂症患者，采用同期双侧多靶点射频热凝治疗。按全国精神外科协作组于1990年制定的评定方法进行疗效评定。结果 392例患者术后2周随访：显著进步104例，进步274例，无效14例，加重0例，有效率96．4％；361例术后远期（6-24个月）随访：恢复26例，显著进步160例，进步154例，无效21例，加重0例，有效率94．18％。；术后除早期一过性并发症外，无远期严重并发症。结论 螺旋CT引导同期双侧多靶点手术治疗难治性精神分裂症疗效显著，对阳性、阴性症状均有显著效果。

Unstaged multi-target stereotactic radiofrequency lesion operation in 392 cases of intractable schizophrenia

Objective To explore the effect and complications of unstaged bilateral multi-target radiofrequency lesion in the treatment of intractable schizophrenia. Methods 392 cases were studied. Spatial coordinates of the target structures was calculated with CT-guieded localization directly and stereotactic headframe indirectly. Using microelectrode record in the operation therapeutic effect was estimated. Results After 2 weeks of operation to 392 cases:efficiency ratio 96.43%;after 6-24 months of operation to 361 cases:efficiency ratio 94.2%. Complication of stereotactic operation was recovered in a short time. Conclusions the efficency of unstaged bilateral multi-target operation is prominent. The radiofreguency target localization by combining CT-guided coordinates and stereotactic headframe is accurate and can reduce risk of complication.