内侧隔-斜角带核:阿片类药物精神依赖外科治疗的新靶点(附34例报告)  

Medial septal diagonal band complex:a new target point of stereotaxic surgery for psychic dependence to opioids(report of 34 cases)

作　　者：王克万[1] 漆松涛[1] 杨开军[1] 

机构地区：[1]南方医科大学附属南方医院神经外科,广东广州510515

出　　处：《中国微侵袭神经外科杂志》2006年第3期112-115,共4页Chinese Journal of Minimally Invasive Neurosurgery

摘　　要：目的探讨单纯双侧内侧隔-斜角带核毁损对阿片类药物精神依赖的治疗作用。方法采用立体定向毁损双侧内侧隔-斜角带核后部治疗34例阿片类药物精神依赖病人,观察手术前后成瘾个体对药物的精神依赖和尼古丁依赖的变化情况,采用简明心理状况检查量表(MMSE)、汉密尔顿抑郁量表(HAMD)和焦虑量表(HAMA)评价手术对记忆、情感的影响。结果随访12￣18个月,精神依赖完全消除25例(73.5%),复吸9例。术后病人学习和记忆力无明显变化,抑郁和焦虑症状有显著性改善(P<0.01)。结论单纯内侧隔-斜角带核毁损治疗阿片类药物依赖有效。Objective To explore the therapeutic effect of destruction of bilateral medial septum-diagonal band complexes on psychic dependence to opioids. Methods Thirty-four patients with psychic dependence to opioids were treated by stereotatic lesioning of bilateral medial septum-diagonal band complexes. The changes in the psychic dependence to drugs and nicotine were observed perioperatively. Mini-Mental State Examination （MMSE）, Hamilton Rating Scale for Depression （HAMD） and Hamilton Anxiety Scale （HAMA） were used to evaluate the influence of the operation on memory and emotion. Results By foUowed-up of 12 to 18 months, psychic dependence was eliminated completely in 25 addicts （73.5%）, and 9 cases relapsed. There was no significant change in learning and memory in all addicts after operation. The mood of depression and anxiety has been significantly improved in postoperative addicts without relapse （P〈0.01）. Conclusion The stereotatic lesioning of medial septum-diagonal band complex is a effective method for psychic dependence to opioids.

关 键 词：隔核 Broca斜角带 阿片相关性障碍 立体定位技术 

分 类 号：R651.11[医药卫生—外科学]