手术戒毒复吸原因及影响因素的对比研究

目的探讨立体定向射频毁损伏隔核手术戒毒后复吸原因及影响因素。方法对2000年7月．2004年11月272例在我院接受定向伏隔核射频毁损手术戒毒的病人进行随访，其中术后复吸58例。分析术后复吸的原因，并与其以往药物戒毒复吸原因及影响因素进行回顾性分析对比研究。结果回到过去吸毒环境、受毒友引诱致复吸17例（29．3％），生活负性事件致复吸30例（51．7％），其他原因致复吸11例，复吸多发生在术后3-6个月。主观欣快感与术前相比无变化28例（48.3％），减弱30例（51．7％），无欣快感增强病例；吸食毒品量及频度与术前相比减少47例（81．0％），无明显变化6例（10．3％），增加5例（8．7％）。结论社会环境因素是手术戒毒复吸的主要原因．心理因素为次要原因。术后3-6个月易发生复吸，吸食毒品欣快感多数减弱或无明显变化。影响术后复吸的因素还与病人受教育程度．吸毒史长短，吸食毒品种类等有关。

Comparative study of reasons and influential factors on relapse after abstinence by ablating nucleus accumbens with stereotactic surgery

Objective To explore the reasons and influential factors on relapse after abstinence by ablating nucleus accumbens with stereotactic surgery for prevention and treatment strategy. Methods Two hundred and seventy-two patients underwent stereotactic surgery of ablating nucleus accumbens by radiofrequency for drug abstinence during July of 2000 to November of 2004. Postoperation follow-up were made to investigate relapse reasons. Fifty-eighteen patients relapsed after surgery. The relapse reasons and influential factors were compared with those in past patients who received drug abstinence by medicine. Results Seventeen patients (29.3%) relapsed because of going back to environment of drug taking and being induced by companions, 30 (51.7%) negative event in life and 11 other reasons. Relapse of most cases occurred 3-6 months after surgery. Compared with pre-operation, subjective euphoria showed no change in 28 (48.3%) cases, attenuated in 30 (51.7%) and none had increased euphoria. Amount and frequency of drug-taking decreased in 47 (81.0%) cases, no obvious change in 6 (10.3%) and increased in 5 (8.7%). Conclusion Social environmental factor is a main cause of relapse after surgery for drug abstinence, whereas psychic factor is secondary. 3-6 months after the surgery is the high-risk period of relapse. The subjective euphoria were decreased or not changed in most cases. There are also other influential factors on relapse such as educational degree of patients, history of drug taking and sorts of the drugs.