立体定向手术对精神分裂症患者顽固性幻觉妄想症状的疗效评定

目的 探讨立体定向手术能否有效消除难治性精神分裂症患者存在的顽固性幻觉妄想症状.方法 对523例存在顽固性幻觉妄想的难治性精神分裂症患者,采用CT定位立体定向双侧杏仁核、内囊前肢、隔区、扣带回等多靶点组合毁损治疗.术后1年由精神科医生对治疗效果进行评定.结果 术前存在顽固性幻觉的患者479例,术后症状完全消除430例、偶发31例,治疗有效率为96.2%.术前存在顽固性妄想的患者491例,术后症状完全消除454例、偶发12例,治疗有效率为94.9%.结论 立体定向脑内多靶点组合毁损治疗可有效消除难治性精神分裂症患者存在的顽固性幻觉妄想症状.

The clinical effect of stereotactic surgery on intractable hallucination and paranoia symptoms

Objective To investigate the clinical effect of stereotactic surgery on intractable illusion and paranoia symptoms of patients with refractory schizophrenia.Methods 523 cases with stubborn hallucination and paranoia symptoms were treated by CT guided stereotactic multi-target lesion of bilateral amygdala,the internal capsule forelimb,septal area and cingulate gyrus.The treatment effect was evaluated by psychiatrists one year later.Results 479 patients had obstinate illusion symptom preoperative,after operation the symptom disappeared in 430 cases and took place by chance in 31 cases,the therapeutic efficacy was 96.2%.491 patients had stubborn paranoia symptom preoperative,after operation the symptom completely eliminated in 454 cases and happened accidental in 12 cases,the therapeutic efficacy was 94.9%.Conclusion The stereotactic surgery of multi-nucleus lesion can be effective in eliminating intractable hallucination and paranoia symptoms of patients with refractory schizophrenia.