手术戒毒持续降低阿片成瘾者对药物的渴求感  

Operation for the treatment of drug addiction persistently decreases drug craving of opioid addicts

作　　者：衡立君[1] 王学廉[1] 贾栋[1] 李维新[1] 高立[1] 高国栋[1] 

机构地区：[1]第四军医大学唐都医院神经外科,西安710038

出　　处：《立体定向和功能性神经外科杂志》2010年第4期218-220,共3页Chinese Journal of Stereotactic and Functional Neurosurgery

基　　金：国家自然科学基金项目(编号:30772219;30930095);优秀留学回国人员创新启动基金项目(编号:TD5042)

摘　　要：目的阿片类药物依赖是一种影响脑功能和行为的复杂疾病,其典型特点为无法控制的药物渴求和不计后果的反复觅药及用药行为。立体定向手术戒毒有望成为新的、有效的药物依赖治疗方法,但其远期有效性有待证实。本研究将探索手术戒毒对阿片成瘾者对药物渴求感的持续作用。方法随机抽取2004～2005年在我科接受立体定向戒毒手术的患者40例。失访7例,纳入研究33例(82.5%)。用视觉模拟评分法量化患者在术前、术后出院时、术后1年、术后5年时对药物的渴求程度。通过比较术后不同时间点评分与术前的变化,评价手术对药物渴求感的抑制效果。结果 33例患者中复吸15例(45.5%),操守18例(54.5%)。渴求程度评分:术前平均9.50、出院时1.96、术后1年2.18、术后5年2.52,术后各时间点渴求感评分与术前相比均显著降低。在复吸患者中,术前吸毒史长短与术后5年渴求感评分呈显著正相关(r=0.55)。另外,出院时渴求感评分在复吸与未复吸患者中差异显著,两组出院时评分与术后5年评分相比均无显著差异。结论立体定向戒毒手术能持续降低患者对阿片类药物的渴求感,其有望成为药物成瘾治疗的重要手段。Objective Opioid addiction,a complex disease that affects both brain function and behavior,is characterized by uncontrollable drug craving thoughts and compulsive drug seeking and taking behavior regardless of consequences.Stereotactic operation for addiction treatment is a new and promising therapeutic method for drug dependence,but its long-term effectiveness is still to be determinated.This study is aimed to investigate the persistent effect of operation on drug craving of opioid addicts.Methods To randomly select 40 patients who received operation for the treatment of opioid addiction in our department from 2004 to 2005.Losing in following-up 7 cases and 33 cases（82.5%） were involved in the study.Using Visual-analogue scale method,we quantified the extent of drug craving of these patients at different time points： pre-operation,check-out time,one year and five years post-operation.By comparing the grade change between different post-operative time points and the pre-operative baseline,we evaluated the suppressing effect of the operation on drug craving.Results Among the 33 cases,relapse happened in 15 cases（45.5%） and non-relapse 18 cases（54.5%）.Grading of craving extent： pre-operation 9.50,check-out time 1.96,one-year post-operation 2.18 and five years post-operation 2.52.Comparing with pre-operation baseline,the craving extent is significantly decreased at all the post-operative time points.In the patients with reinstatement,the period of drug using history is positively correlated with the craving extent five years post-operation（r = 0.55）.In addition,at the time of check-out,the craving extent grading is significantly different between relapse and non-relapse groups.However,in both groups,there are no essential differences between craving grading at check-out time and that of five years after operation,respectively.Conclusion Stereotactic operation for addiction treatment could persistently decrease opioid craving of the addicts and it is a promising method for the drug addiction thera

关 键 词：伏核 立体定向 药物依赖 药物成瘾 渴求感 

分 类 号：R749.1[医药卫生—神经病学与精神病学]