单靶点与多靶点联合毁损术治疗阿片类药物成瘾的长期疗效  

Long-term therapeutic effect of combined lesioning of single-target and multi-target for opiate addiction

作　　者：常崇旺[1] 王学廉[1] 葛顺楠[1] 吴鹤鸣[1] 赵海康[1] 常晓赞[1] 王鹏[1] 方伟[1] 李敏[1] 李定君[2] 明扬[2] 汪崇琦 曾彦萍 汪鲁刚 蔡美玲 尹忠民 吴静 卢旺盛[6] 孙艳杰[6] 韩凌[6] 李殿友[7] 陈美君 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 [2]泸州医学院第一附属医院,646000 [3]三九脑科医院,广州510510 [4]解放军458医院,广州510602 [5]解放军463医院,沈阳110042 [6]解放军海军总医院,北京100037 [7]上海交通大学附属瑞金医院,200025

出　　处：《中国微侵袭神经外科杂志》2011年第2期51-55,共5页Chinese Journal of Minimally Invasive Neurosurgery

基　　金：国家十一五科技支撑计划课题(编号:2007BAI0703)

摘　　要：目的比较伏隔核损毁术与伏隔核加其他靶点联合损毁术治疗阿片类药物成瘾的长期疗效。方法从我国7个医疗中心接受过双侧伏隔核毁损术(单靶点)与双侧伏隔核加其他靶点联合毁损术(多靶点)治疗阿片类药物成瘾的两组病人中分别随机抽取75名病人,术后第5年回顾性随访研究,比较两组的复吸率和副反应发生率。结果单靶点组和多靶点组各有62例和60例病人接受并按计划完成随访。两组间复吸率和非特异性副反应的病人比例差异均无统计学意义(P=0.678,P=0.780)。多靶点组特异性副反应的比例与严重程度均高于单靶点组,差异有统计学意义(P=0.011,P=0.008)。结论与立体定向伏隔核单靶点损毁术相比,伏隔核加其他靶点联合损毁术治疗阿片类药物成瘾的复吸率未降低,但特异性副反应发生率明显增高。Objective To compare the long-term therapeutic effects of stereotactic lesioning of the nucleus accumbens and lesioning of the nucleus accumbens combined with others targets for opiate addiction.Methods Seventy-five patients were selected randomly and equally from patients with opiate addiction of two groups who underwent stereotactic lesioning of the bilateral nucleus accumbens（single-target group） and lesioning of the bilateral nucleus accumbens combined with others targets（multi-target group） respectively in 7 medical centers of China.The retrospective follow-up research 5 years after the operation was executed to compare the rate of relapse and incidence rate of side effects between the two groups.Results Sixty-two patients in single-target group and 60 ones in multi-target group received and completed the follow-up.There was no a significant difference between relapse rate and incidence of non-specific side reaction in the two groups（P=0.678,P=0.780 respectively）.The incidence rate and severity of specific side reaction in multi-target group were higher than those in single-target group（P=0.011,P=0.008 respectively）.Conclusions Compared with stereotactic lesioning of the nucleus accumbens,there is no decrease in the relapse rate after combined lesioning of the nucleus accumbens with others targets for opiate addiction,but side reaction rate increases significantly.

关 键 词：阿片相关性障碍 立体定位技术 伏隔核 毁损术 

分 类 号：R651.1[医药卫生—外科学]