立体定向术治疗精神病性症状的躁狂症33例临床分析  

Follow-up study on refractory mania company with psycho-symptom with brain stereotaxis therapy

作　　者：鄢林[1] 蔡溢[1] 黄红星[1] 匡卫平[1] 周彬[1] 朱勇[1] 陈小峰[1] 李波[1] 

机构地区：[1]湖南省第二人民医院功能神经外科,长沙410007

出　　处：《立体定向和功能性神经外科杂志》2015年第1期9-12,共4页Chinese Journal of Stereotactic and Functional Neurosurgery

基　　金：湖南省第二人民医院重点专科建设资助(编号:2012)

摘　　要：目的探讨脑立体定向术对治疗难治性伴有精神病性症状的躁狂症远期疗效及安全性。方法采用立体定向术治疗难治性伴有精神病性症状的躁狂症33例,术后2年以上进行随访,采用临床总体印象量表、阳性症状和阴性症状量表及Bech-Rafadlsen躁狂量表(BRMS)对远期疗效进行评定,采用日常能力量表、社会功能缺陷筛选量表、韦氏成人智力量表及韦氏记忆量表评估手术安全性。结果依据临床总体印象量表评定,明显进步7例,中度进步11例,稍有进步11例,无变化4例,有效率87.9%。手术前后各量表评分差异均有统计学意义(P<0.01),术后无严重远期并发症和后遗症。结论脑立体定向术治疗难治性伴有精神病症状的躁狂症远期疗效稳定,安全性好;同时术后应重视药物维持治疗和社会功能的恢复。Objective To explore the long--term effect and security of refractory mania company with psycho--symptom disorder with brain stereotaxis multi--target therapy technique. Methods A total of 33 patients with refractory mania company with psycho--symptom disorder were treated with brain stereotaxis multi--target therapy and were followed up over 2 years. The scores of clinical Global Impression （CGI）, Positive and Negative Symptom Scale（PANSS）, Bech --Rafadlsen manic scale（BRMS）,Wechsler Adult Intelligence Scale（WAIS） ,Wechsler Memory Scale（WMS）, Actives of Daily living（ADL）, and compared before and after the operation. Results Social Disability Screening Schedule（SDSS） were In 33 patients, 7 obviously progress, 11 Moder- ate progress,ll Slight progress,4 bad effect. There was a significant difference in the scales be- fore and after the operation（P〈0. 01）. No severe complications and sequelae occurred. Conclusion Stereotaxis multi--target therapy is effective and safe for refractory mania company with psy- cho-symptom disorder. After the operation,medicine therapy should be maintained and focus on recovery of social functions.

关 键 词：立体定向术 躁狂症 远期疗效 安全性 

分 类 号：R749.41[医药卫生—神经病学与精神病学]