精神分裂症立体定向脑内多靶点联合毁损术的疗效观察

【目的】观察精神分裂症立体定向脑内多靶点联合毁损术治疗的疗效，探讨该治疗方法的有效性及安全性。【方法】采用1．5T核磁共振结合立体定向规划系统定位，对32例药物难治性精神分裂症患者实施同期双侧脑内多靶点射频热凝毁损术。【结果】32例患者术后4周随访：显著进步17例，进步11例，无效4例，加重。例。有效率87．5％。远期随访（12～48个月）：恢复3例，显著进步14例，进步9例，无效4例，失访1例，加重1例，有效率81．25％。术后早期有高热，尿失禁，局灶性脑出血等一过性并发症，无远期并发症及死亡病例。【结论】对药物难治性精神分裂症立体定向脑内多靶点联合毁损术是安全，有效的治疗方法。

Observation on the Effect of Multi-target Stereotactic Radiofrequency Lesion Operation for the Treatment of Patients with Schizophrenia

Objective]To explore the effect and safety of multi-target stereotactic radiofrequency lesion in the treatment of schizophrenia. Methods] Thirty two cases of intractable schizophrenia were operated by homeochronous bilateral multi-target radiofrequency lesion with 1.5T nuclear magnetic resonance and stereotactic system. Results] Thirty two cases were followed up for 4 weeks after operation. Among all patients, 17 patients had significant improvement, 11 had improvement and 4 had no change. The effective ratio was 87.5%. Among 31 cases with follow- up from 12 to 48 months, 3 patients recovered, 14 had significant improvement, 9 had improvement, 4 patients had no change and 1 was deteriorate. The effective rate was 81.25%. The complications after operation at the early stage were hyperpyrexia, urinary incontinence and focal cerebral hemorrhage, but they recovered in a short time. No long- term complication and death case were found. Conclusion] Multi-target stereotactic radioffequency lesion surgery is safe and effective therapy for intractable schizophrenia.