立体定向手术治疗难治性精神分裂症(附256例报告)

目的:探讨立体定向技术和多靶点组合对难治性精神病的治疗意义,综合评估临床疗效。方法:在立体定向基础上,应用CT、电阻值和微电极电生理进行核团定位,对256例难治性精神病患者,采用杏仁核、内侧隔区、扣带回等多靶点组合射频热凝治疗。应用临床疗效总评量表(clinical grobal impressions scale,CGI)、简明精神病评定量表(brief psychiatric rating scale,BPRS)、阴性和阳性综合量表(the postitve and negative syndrome,PNSS)精神病评定量表在术后6个月对治疗效果进行评定。结果:依据减分率标准,256例患者中,显著进步140例,进步108,无变化8例。手术前后量表评分有显著差异(P<0.05=无严重并发症和后遗症发生。结论:多靶点组合的立体定向技术是难治性精神病的有效治疗方法之一,靶点组合设计和亚核团的准确定位,对提高疗效,降低并发症有较大意义。

Therapeutic Efficacy of 256 Patients with Refractory Psychosis by Stereotactic Neurosurgery

Objective:To analyze the significance of intractability psychosis in use of mutiple target and Stereotactic surgery.Methods: 256 patients were treated by stereotactic technique connect with CT、microelectrode and electric impedance methods with bilateral multiple nuclei lesion by radio-frequency thermocoagulation.The therapeutic effects were estimated with CGI 、BPRS and PNSS.Rusults:On the sixth month after operation,there are significance different in measuring scale between preoperative and postoperative(p<0.05 =Base on the code of decreased rate,140 patients were respectively improved,108patients were improved and 8 patientswere invalid,no complication and sequela taken occurrenced.Conclusion:The stereotactic technique with multiple locations might be an effective method to treat intractability psychosis.It might be a great significance to improve the effect,especially using new mutiple targets and accuracy location of subset nuclei.