杏仁核毁损术的临床应用  

A technical report on clinical application of selective amygdala lesions

作　　者：陈成雨[1] 刘琨[1] 丁福忠[1] 刘运振[1] 韩凤珍[1] 

机构地区：[1]山东省济宁市精神病防治院神经外科,272051

出　　处：《立体定向和功能性神经外科杂志》2002年第1期26-28,共3页Chinese Journal of Stereotactic and Functional Neurosurgery

基　　金：济宁市科委立项课题 ( 99-4 1)

摘　　要：目的　研究杏仁核毁损在功能性疾病中的应用价值及对神经电生理的影响。方法　采用脑立体定向技术对顽固性癫痫 43例 ;难治精神病 2 7例 ;冲动性人格障碍 4例 ;精神发育迟滞伴发行为障碍 3例 ,进行选择性杏仁核毁损 ,单侧毁损 12例 ,双侧毁损 6 5例。对部分患者进行了手术前后医学心理、神经电生理检查对照。对难治性精神病患者进行了手术前后BPRS及各因子分析对照。结果　 43例顽固性癫痫患者按国际抗癫痫联盟制定的手术治疗癫痫疗效的标准 :痊愈 10例、显进 16例、进步 12例、无效 5例。难治性精神病通过BPRS及各因子分析 ,其中BPRS、ANDP、ACTV、HOST手术前后对照具有显著的差异性 (P <0 0 1) ,综合疗效评定 :痊愈 2例、显进10例、进步 13例、无效 2例。对冲动性人格障碍及精神发育迟滞所致的冲动、伤人、毁物等行为障碍改善明显。对EEG无明显影响 ,而患者的智能、记忆无明显变化。Objective To study the application of amygdala lesions in functional diseases and effect on neuroelectrophysiology.Methods There were 43 patients with intractable epilepsy,27 patients with refractory spychosis,4 patients with impulsive personality disorder,3 patients with mental retardation accompanied with behaviorder.All the patients were performed selective amygdala lesions through brain stereotaxis technolong them 12 patients were lesioned in one side of amygdala and 65 patients in both sides.Compare the results of before and after operations on medical psychological assesments and electrophysiological examinations in partial patients.And compare the BPRS total scores and factor scores of before and after operations in refractory psychosis patients,respectively.Results In 43 intractable epilepsy patients,10 patients were cured,16 patients were marked improvement,12 patients were improvement,5 patients were no improvement.There were significant differences(P<0.01) on BPRS.ANDP,ACTV,HOST in refractory psychosis patients,and general efficacy assessment showed cure in 2,marked improvement in 10,improvement in 13,and no improvement in 2.There were more improvement in behavioral disorder.Such as impulsive,aggressive and destructive behavior in impulsive personality disorder and mental retardation patients,and There were no variance in intelligence,memory and electroencephalography.Conclusion There were geat clinical applications of amygdala lesion in treatment of functional dieases.

关 键 词：杏仁核 癫痫 精神病 脑电图 临床应用 杏仁核毁损术 

分 类 号：R742.105[医药卫生—神经病学与精神病学]