立体定向颅内多靶点毁损术治疗难治性精神分裂症的远期预后分析  

Long-term therapeutic effects of stereotactic bilateral multiple-targer combined with radiofrequency ablation on intractable psychosis

作　　者：陈邱明 袁邦清[1] 林川凎[1] 林立[1] 吴贤群[1] 王飞红[1] 

机构地区：[1]中国人民解放军第476医院神经外科,福州350002

出　　处：《立体定向和功能性神经外科杂志》2013年第6期341-344,共4页Chinese Journal of Stereotactic and Functional Neurosurgery

摘　　要：目的探讨立体定向手术治疗难治性精神分裂症的远期疗效。方法回顾性分析应用立体定向多靶点毁损手术治疗的826例难治性精神分裂症患者的临床资料,对术后回访超过5年的348例患者设立非手术对照组,采用简明精神病量表(BPRS)、阳性和阴性症状量表(PANSS)、社会功能缺陷量表(SDSS)和日常生活能力量表(ADL)等对远期预后进行评定。结果长期随访,手术组与非手术组(BPRS)中的激活因子分、PANSS中的攻击危险性和偏执/好斗因子分有显著性差异(P<0.01),SDSS和ADL评分两组间的差异无显著性(P>0.05)。结论脑立体定向手术对临床确诊的难治性精神分裂症靶症状疗效是肯定的,对患者的社会和生活能力无明显影响。Objective To explore the long--term therapeutic effects of stereotactic bilateral mul- tiple--targer combined with radiofrequency ablation on intractable psychosis. Methods Clinical data of 826 patients with intractable psychosis were analyzed retrospectively. 348 cases which operated over 5 years were re--assessed with the same matched patients without psychosurgery as controls. All patients were assessed with scales for clinical symptoms（brief psychiatric rating scale, BPRS; postive and negative symptom, Scale, PANSS） and Social functions （social disability screening schedule, SDSS, activity of daily living scale,ADS）. Results Long--term follow--up showed that the patients with surgery had lower scores of PANSS subscales of aggressive and paranoid/pugnacity, and higher scores of BPRS activity than patients with no operation. There were no significant differences of SDSS and ADL Scores between both the groups. Conclusion The long--term therapeutic effects of stereotactic operation used to treat target symptoms of intractable psychosis is sure. There were less influence on social and life skills of patients after operation.

关 键 词：立体定向 难治性精神病 远期预后 

分 类 号：R749.05[医药卫生—神经病学与精神病学]