难治性精神病外科治疗效果评价

目的综合评价难治性精神病外科治疗的临床效果及手术对难治性精神病人的神经生理、记忆、智能的影响。方法采用脑立体定向技术对临床确诊的难治性精神病精神分裂症选杏仁核、扣带回、内囊前肢等脑内不同靶点进行单靶点或多靶点联合毁损,对部分患者进行了手术前后医学心理、神经电生理检查对照分析,同时对难治性精神分裂症患者进行了手术前后BPRS及各因子分析对照。结果难治性分裂症通过BPRS及各因子分析,其中BPRS、ANDP、ACTV、HOST手术前后对照具有显著的差异性（P〈0．01）,综合疗效评定：痊愈2例;显进64例;进步41例;无效20例。结论脑立体定向技术对临床确诊的难治性精神病靶症状疗效是肯定的,手术对患者记忆、智能及脑电图无明显影响。

Evaluation of clinical effect of surgery on refractory psychosis

Objective To evaluate the clinical effect of surgical treatment for refractory psychosis, and explore the influence on neurophysiology, memory, and intelligence of patients after operation. Methods Single or muhitargets joint damage were used to the 127 patients with refractory schizophrenia through the brain stereotactic technology. All patients had accepted medical psychology, BPRS and its factors and neural physiological check before and after surgery. At the same time, BPRS and its factors were compared and analyzed in patients with schizophrenia. Results There were significant difference on the scores of BPRS, ANDP, HOST between preoperative and postoperative （P 〈 0. 01 ）. The comprehensive effect evaluation was 2 cases healed, 64 cases not able progressed, 41 cases progressed, 20 cases invalid. Conclusion The effective of the brain stereotactic technology used to treat target symptoms of refractory psychosis is sure. There were less influence on intelligence , memory and EEG of patients after operation .