立体定向颅内多靶点毁损术治疗难治性精神障碍疗效分析  

Selection and combination of targets for stereotactic bilateral multiple-targer combined with radiofrequency ablation on intractable psychiatric disorders

作　　者：陈邱明 袁邦清[1] 林川凎[1] 黄绍宽[1] 吴贤群[1] 林立[1] 沈汉超[1] 王飞红[1] 杨光[1] 苏同刚[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》2014年第5期257-260,共4页Chinese Journal of Stereotactic and Functional Neurosurgery

摘　　要：目的探讨立体定向选择性多靶点联合毁损治疗难治性精神障碍的靶点组合及疗效。方法回顾性分析2005年5月至2011年6月应用立体定向多靶点毁损手术治疗的1026例难治性精神障碍患者的临床资料,所有病例均在CT引导下行选择性多靶点联合毁损,术前应用CT进行靶点定位,手术前后应用阳性与阴性症状量表(PANSS)、耶鲁-布朗强迫量表(Y-BOCS)、汉密尔顿焦虑量表(HAMD)、汉密尔顿抑郁量表(HAMA)等量表进行疗效评定。结果经过量表术前、术后(三个月、一年、三年)评估,评分差值P<0.05。1026例患者中,恢复242例,显著进步514例,进步188例,无效82例,无严重并发症和后遗症发生。结论根据不同的症状设计不同的靶点组合,对提高疗效有较大意义。Objective To explore targets selection and long- term outcome of multitarget radiofrequency lesion operation in patients with intractable psychiatric disorders.MethodsClinical data of 1026 patients with intractable psychiatric disorders were analyzed retrospectively.CT-guided stereotactic selective multiple target lesioning were performed in all patients.The therapeutic effects were estimated with positive and negative symptom scale（PANSS）,YaleBrown obsessive compulsive rating scale（Y- BOCS）,Hamilton anxiety scale（HAMA）and Hamilton depression scale（HAMD）at the pre-and post- surgery.Results 242 patients were cured,514 patients were markedly improved.188 patients were improved,and 82 patients were invalid The scores of the scales（PANSS,Y-BOCS,HAMA,HAMD）significantly decreased after surgery（P〈0.05）.Conclusion Chossing different targets according to different symptoms can improve the efficiency.

关 键 词：立体定向 难治性精神障碍 靶点选择及组合 

分 类 号：R749.05[医药卫生—神经病学与精神病学]