内侧隔-斜角带核:阿片类药物精神依赖外科治疗的新靶点(附34例报告)

目的 探讨单纯双侧内侧隔-斜角带核毁损对阿片类药物精神依赖的治疗作用。方法 采用立体定向毁损双侧内侧隔一斜角带核后部治疗34例阿片类药物精神依赖病人，观察手术前后成瘾个体对药物的精神依赖和尼古丁依赖的变化情况．采用简明心理状况检查量表（MMSE）、汉密尔顿抑郁量表（HAMD）和焦虑量表（HAMA）评价手术对记忆、情感的影响。结果 随访12-18个月，精神依赖完全消除25例（73．5％），复吸9例。术后病人学习和记忆力无明显变化，抑郁和焦虑症状有显著性改善（P〈0．01）。结论 单纯内侧隔一斜角带核毁损治疗阿片类药物依赖有效。

Medial septal diagonal band complex: a new target point of stereotaxic surgery for psychic dependence to opioids (report of 34 cases)

Objective To explore the therapeutic effect of destruction of bilateral medial septum-diagonal band complexes on psychic dependence to opioids.Methods Thirty-four patients with psychic dependence to opioids were treated by stereotatic lesioning of bilateral medial septum-diagonal band complexes.The changes in the psychic dependence to drugs and nicotine were observed perioperatively.Mini-Mental State Examination(MMSE),Hamilton Rating Scale for Depression(HAMD) and Hamilton Anxiety Scale(HAMA) were used to evaluate the influence of the operation on memory and emotion.Results By followed-up of 12 to 18 months,psychic dependence was eliminated completely in 25 addicts(73.5%),and 9 cases relapsed.There was no significant change in learning and memory in all addicts after operation.The mood of depression and anxiety has been significantly improved in postoperative addicts without relapse(P<0.01).Conclusion The stereotatic lesioning of medial septum-diagonal band complex is a effective method for psychic dependence to opioids.