伏隔核毁损术戒毒术后患者复吸原因研究  

Clinical investigation and analysis of relapse status of patients who underwent bilateral nucleus accumbens ablation with stereotactic surgery

作　　者：洪磊[1] 王学廉[2] 吴佳颖[3] 高国栋[4] 

机构地区：[1]第四军医大学唐都医院神经外科,西安710038 [2]第四军医大学唐都医院功能性脑病研究所,西安710038 [3]第四军医大学预防医学系 [4]第四军医大学唐都医院全军功能性神经外科研究所,西安710038

出　　处：《立体定向和功能性神经外科杂志》2007年第4期196-198,共3页Chinese Journal of Stereotactic and Functional Neurosurgery

基　　金：总后勤部卫生部临床高新技术重大项目(编号:200218);总后勤部卫生部全军医学科研"十五"计划资助项目(编号:IMT402)

摘　　要：目的调查伏隔核毁损术后患者复吸原因,比较手术戒毒与保守治疗的效果,评价手术戒毒疗效。方法回顾性调查手术后观察期2年以上的复吸患者43例,通过家庭走访、门诊、电话、书信、问卷等方式,调查复吸原因,操守时间,术前、术后吸食毒品量变化、对毒品的心理渴求感及吸食毒品后的主观感觉变化,通过自身对比,分析比较手术与以往保守治疗戒毒的效果及复吸原因。结果失随访9例,主要复吸原因为接触与原成瘾相关的情境(28例,占82.4%)和生活负性事件的应激反应(6例,占17.6%);手术后的操守时间明显长于以往保守治疗后的操守时间;手术后每日吸食毒品量明显少于以往保守治疗后的吸食量;以手术组为研究对象,对操守时间及每日吸食毒品量按复吸原因分组进行成组t检验均无显著性差异(P>0.05)。结论手术戒毒与保守治疗相比,操守时间长,复吸后每日吸食毒品量明显减少,对毒品的心理渴求感降低。Objective To investigate into ablating the nucleus accumbens with stereotactic reasons of relapse in addicts after treatment by surgery and evaluate the efficacy of the surgery. Methods A retrospective analysis was made of 43 relapse cases with postoperative observations longer than 2 years. Information including reasons of relapse, drug--free time, change in dose of importation before and after surgery, psychological craving for drug and subjective sensation was collected by investigation, using uniform questionnaires by face--to--face and telephone interview. Comparison of therapeutic effects between surgical and expectant treatment was made through subject contrast method. Results Among the 43 cases,34 were successfully followed-- up. Main reasons of relapse included temptation by drug surroundings（28 cases ,82. 4%）and stress to negative incidents in life（6 cases ,17.6%）. Compared with patients subjected to expect- ant treatment, drug--free time after treatment was significantly prolonged in patients undergoing stereotactic surgery and relapse dose decreased too. Postoperative drug--free time and relapse dose ,as reasons for relapse, were compared through, which suggested no significant difference （P〉0.05）. Conclusion Compared with expectant treatment, the treatment of ablating the nucleus accumbens with stereotactic surgery is advantageous in prolonged drug--free time, decreased relapse dose and alleviated psychological craving for drug.

关 键 词：立体定向手术 复吸 戒毒 伏隔核 

分 类 号：R996[医药卫生—毒理学]