立体定向双侧内囊前肢毁损治疗难治性强迫症(五年随访研究)

目的 探讨内囊前肢毁损治疗难治性强迫症的长期临床疗效及不良反应.方法 对32例难治性强迫症病人,采用MRI导向市体定向双侧内囊前肢毁损治疗.术前及术后5年对患者进行相关量表的评测.结果 32例手术病人中19例强迫症状完全消失,8例明显改善,3例稍有改善,2例无明显变化.3例患者出现意志减弱.其中1例经过系统心理治疗后恢复;2例病人术后出现轻度情感和行为幼稚.结论 MRI导向市体定向双侧内囊前肢毁损术定位精确、安全、显效迅速,对难治性强迫症患者有明显而稳定的疗效,并可提高患者的生活质量,恢复礼会功能.

5 years follow up of the clinical effect of bilateral capsulotomy in patients with refractory obsessive-compulsive disorde

Objective To study the clinical effect and complications of bilateral capsulotomy in patients with refractory obsessive-compulsive disorders. Method 32 cases with refractory obsessive-compulsive disorder underwent MRI guided stereotactic bilateral anterior eapsulotomy. Pre-operative and 5 years post-operative psychiatric rating scales were evaluated. Results In all of 32 cases, 19 cases had OCD symptoms free,8 cases had significant improvement, 3 cases had partial improvement and 2 cases had no improvement. 3 cases experienced hypobulia and one of them recovered after systematic psychological and behavior therapy. 2 cases showed emotional and behaviour infantility. Conclusions MRI guided stereotactic bilateral capulotomy is a precise, safe, promising therapy for refractory. It also improves the quality of life of patients and restore social function.