阿片类药物依赖者立体定向脑深部核团毁损手术前患者心理症状特征  

Characteristics of psychological symptoms in opium-dependent patients before stereotaxic lesion of nuclear cluster in deep brain

作　　者：吕博川[1] 李智勇[2] 杜鹏[2] 魏学忠[2] 

机构地区：[1]解放军沈阳军区总医院神经外科神经心理室,辽宁省沈阳市110016 [2]解放军沈阳军区总医院神经外科,辽宁省沈阳市110016

出　　处：《中国临床康复》2006年第2期18-20,共3页Chinese Journal of Clinical Rehabilitation

摘　　要：目的:了解主动要求立体定向脑深部核团毁损术治疗药物依赖的群体术前心理症状的特征。方法:选择2004-07/11自愿在沈阳军区总医院神经外科手术治疗的阿片类药物依赖连续病例34例。采用90项症状自评量表独立测试评估心理健康状况,计算机获得结果。与国内常模和国内燕殿学组、朱军红组、万萍组所测结果进行统计学分析。结果以“均值±标准差”表示,应用SPSS软件对测量结果进行t检验。结果:34例患者均完成量表测试,全部进入结果分析。①主动要求手术治疗的患者,多为32岁左右的男性已婚的个体经营者患者。依赖物质以海洛因为主;首吸年龄小;持续时间长;滥用方式多;复吸率高,并以心理依赖为主。②症状自评量表测查,总分中最高分374分、160分以上者23例占67.6%,平均分高于国内常模,差异有显著性[(38.29±4.08),(24.92±18.4),P<0.001]。阳性项目数最高分86分、43分以上者24例占70.6%,平均分高于国内常模,差异有显著性。③心理障碍总患病率高达91.2%。心理障碍因子分超出常模的构成比从高到低分别为:抑郁和躯体化、焦虑、强迫、敌对、精神病性和其他、偏执、恐怖以及人际关系。心理障碍显现强度的排列为,抑郁、敌对、强迫和其他、躯体化、焦虑、人际关系、偏执、精神病性以及恐怖。④与国内燕殿学组比较差异无显著性;与朱军红组比较,仅强迫因子差异有显著性;与万萍组所测结果比较,躯体、抑郁、焦虑、敌对、恐怖和精神病症状因子差异均有显著性。结论:阿片类药物依赖的患者术前心理障碍是普遍存在的临床问题。了解患者术前心理症状的特征,便于围手术期医学干预方法的选择。有利于对术后疗效做出科学的评价。AIM： To investigate the characteristics of preoperative psychological symptoms in opium-dependent group who actively asked for stereotaxic lesion of nuclear cluster in. deep brain. METHODS： Thirty-four patients with continuous opium-dependence, who were voluntarily treated with operation in the Department of Neurosurgery, General Hospital of Shenyang Military Area Command of Chinese PLA between July and November 2004, participated in the study. Their psychological health status was assessed with symptom checklist-90 （SCL-90）, and the results were obtained with computer, and compared with national norms and national Yah DX group, Zhu JH group and Wan P group, the results were also statistically analyzed. The results were expressed as Mean±SD, and the t test was applied to the measurement data with SPSS software. RESULTS： All the 34 patients finished the test and entered the analysis of results.① Most of the patients, who actively asked for operation, were male married individual manager about 32 years old. The dependent drug was mainly heroin, the age of the first take was young, there was long duration, many abuse manners, high retaking, and most were psychological dependent. ②The highest total score of SCL-90 was 374, and the total score was above 160 in 23 cases （67.6%）, and the average score was significantly higher than that of national norms [（38.29±4.08）, （24.92±18.4）, P 〈 0.001]. The highest score of positive items was 86, and the score was above 43 in 24 cases （70.6%）, the average score was significantly higher than that of national norms. ③ The total prevalence rate of psychological obstacle reached 91.2%. The constituent ratio of factor score exceeding norms from high to low was depression and somatization, anxiety, obsession-compulsion, hostility, psychoticism and others, paranoid ideation, phobic anxiety and interpersonal sensitivity respectively. The manifested intensity of psychological obstacles in order were depression, hostility, obsession-compulsion and other

关 键 词：依赖(心理学) 阿片 海洛因依赖 问卷 

分 类 号：R749.611[医药卫生—神经病学与精神病学]