扣带回毁损术后尿失禁解剖及临床分析  

The anatomic and clinical study on urinary incontinence in postoperation of stereotactic cingulotomy

作　　者：周剑云[1] 郭常利[1] 梁强[1] 刘建峰[1] 王争[1] 赵爱军[1] 宋剑[1] 郝拴发[1] 

机构地区：[1]河北医科大学第一医院神经外科,石家庄050031

出　　处：《立体定向和功能性神经外科杂志》2004年第6期335-337,共3页Chinese Journal of Stereotactic and Functional Neurosurgery

摘　　要：目的　研究扣带回毁损术后尿失禁的原因及防治措施。方法　回顾分析 10例顽固性精神病的立体定向扣带回毁损术术后发生尿失禁的状况 ,解剖观察 12例扣带回毁损灶和胼周动脉及其分支的关系。结果　术后因扣带回毁损术引起的尿失禁 6例 ,1周内恢复者 1例 ,1～ 3个月恢复 3例 ,3个月后仍未恢复者 2例。旁中央动脉是供应旁中央小叶的主要血管 ,旁中央动脉位置相对恒定 ,且两侧旁中央动脉不对称分布 ,扣带回毁损灶后界波及旁中央动脉的有 9例 ,其中波及双侧旁中央动脉的有 5例。结论　扣带回立体定向毁损术的疗效是肯定的 ,其术后常见的并发症尿失禁 ,在不影响疗效的基础上通过精确细化靶点坐标等措施是应该可以得到防治的。Objective To study the reason and the preventivemeasures on urinary incontinence in postoperation of stereotactic cingulotomy.Methods The status on urinary incontinence of 10 patients with refractory psychiatric disease treated by stereotactic cingulotomy were reviewed and analyzed. The anatomic relationship between cingulotomy location and pericallosal artery as well as its branches were observed.Results There were 6 cases with urinary incontinence because of cingulated lesion.Among of them,one case recovered within 1 week,3 cases recovered within 1～3 months,and 2 cases didn't recovered after 3 months yet.Paracentral artery is the essential blood vessel to serve paracentral labe,the position of paracentral artery is comparatively invariable,bilateral paracentral artery distributes dissymmetrically.9 cases were observed that cingulated lesion site spread to paracentral artery,5 cases among of them spread to bilateral paracentral artery.Conclusion The efficiency is positive of stereotactic cingulotomy.Urinary incontinence is familiar complication of postoperation which can be prevented by applying some measures such as adjusting exact target coordinates.

关 键 词：扣带回毁损术 顽固性精神病 立体定向术 解剖 尿失禁 

分 类 号：R749.05[医药卫生—神经病学与精神病学]