伏隔核毁损术对阿片类药物依赖患者人格长期影响的研究(附术后5年随访报告)  

Associations between personality changes and nucleus accumbens lesion of opioid addicts

作　　者：赵海康[1,2] 王学廉[1] 耿宁[1] 李楠[1] 汪鑫[1] 葛顺楠[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 [2]西安医学院第二附属医院神经外科

出　　处：《立体定向和功能性神经外科杂志》2013年第4期197-202,共6页Chinese Journal of Stereotactic and Functional Neurosurgery

基　　金：国家"十一五"科技支撑计划课题<对已有防复吸疗法临床再评估>(编号:2007BA107B03)

摘　　要：目的研究伏隔核毁损术对接受了该手术的阿片类药物依赖患者人格的长期影响。方法从在我中心2000年7月至2004年11月接受了双侧伏隔核毁损术以戒除阿片类药物依赖的272例患者中随机抽取78例患者,组成手术组;与未接受手术的阿片类药物依赖患者配对成功72例,组成未手术组。对两组患者进行是否复吸,艾森克人格量表(EPQ)及健康状况问卷(SF-36)量表等的调查。结果手术组复吸30例,复吸率61.5%(48/78)。与中国EPQ常模比较,未手术组的情绪稳定性(N)、精神质(P)维度得分升高(P<0.05),掩饰性(L)维度得分降低(P<0.05);手术组的L维度得分降低(P<0.05)。与未手术组比较,复吸组在N维度得分降低(P<0.05)。与未复吸组比较,复吸组在P维度得分升高(P<0.05)。患者是否接受手术与其P、N维度负相关(P<0.05),手术组患者的P和N得分偏低。结论手术后5年,伏隔核毁损术对接受了该手术的阿片类药物依赖患者人格的N维度仍可能产生影响,术后高P倾向的患者更容易复吸。Objective This article aimed to investigate associations between personality changes and nucleus accumbens absence. Methods Randomly selected 78 cases from 272 patients who received stereotactic lesion of bilateral nucleus accumbens to treat opioid addiction in the Centre, formed the surgery group. 72 non--surgery opioid addicts were successfully paired to the accepted operation one, formed the non--surgery group. The patients all were invited to the out- patient department and accepted the face to face interview. Used urine test, naloxone provocative test and hair testing to verify whether the patients relapsed or not. Eysenck Personality Ques- tionnaire （EPQ） and 36 Health Survey Questionnaire （SF--36） were employed. Results 30 cases of the surgery group relapsed, and the non--relapse rate was 61.5% （48/78）. Compared with the Chinese Norm the neuroticism（N） and psychoticism（P） dimensions of EPQ of the non--sur- gery group were higher （P〈0. 05） while lie （L） dimension was lower （P〈0. 05）. N dimension of the relapse group and L dimension of the surgery group were lower than the non--surgery group（P〈0.05）. P dimension of the relapse group was higher than the non--relapse group （P〈0. 05）. Extraversion（E） dimention was relatively stable among these groups. Conclusion Al- though the research couldn＇t exclude the influence of other factors it still was the fact that the op- eration might make the P and N dimetions of the opioid addicts discreasing. Higher P may lead to easier relapse.

关 键 词：阿片类药物依赖 立体定向 伏隔核毁损术 人格 

分 类 号：R996[医药卫生—毒理学]