脑立体定向手术治疗难治性精神病  

Stereotactic brain surgery for refractory psychosis

作　　者：钟务招 罗云辉 刘飞龙 杨绮帆 ZHONG Wu-zhao;LUO Yun-hui;LIU Fei-long;YANG Qi-fan(Department of Neurosurgery,Nanchang 334 Hospital,Jiangxi Province,Nanchang330012,China)

机构地区：[1]南昌三三四医院神经外科,江西南昌330012

出　　处：《中国当代医药》2021年第13期82-84,共3页China Modern Medicine

基　　金：江西省卫生计生委科技计划项目(20197071)。

摘　　要：目的探讨脑立体定向手术治疗难治性精神病的效果。方法选取2017年10月~2019年11月在南昌三三四医院就诊的60例难治性精神病患者作为研究对象,采用随机数字表法分为对照组与观察组,每组各30例。对照组患者采用非手术治疗,观察组患者采用脑立体定向手术。比较两组患者的氯氮平用药剂量、功能独立自主量表(FIM)评分、粗大运动功能量表-88(GMFM-88)评分、粗大运动功能量表(GMFCS)评分、格拉斯哥预后量表(GOS)分级。结果治疗6个月后,观察组氯氮平日均用药剂量低于对照组,差异有统计学意义(P<0.05);治疗6个月后,两组FIM评分、GMFM-88评分、GMFCS评分均高于治疗前,且观察组的FIM、GMFM-88、GMFCS评分高于对照组,差异有统计学意义(P<0.05);治疗6个月后,观察组GOS分级优于对照组,差异有统计学意义(P<0.05)。结论难治性精神病患者采用脑立体定向手术治疗的效果较好,可减少使用精神药物,利于患者神经功能恢复,预后较好。Objective To explore the effect of stereotactic brain surgery in the treatment of refractory psychosis.Methods A total of 60 patients with refractory mental illness who were treated in Nanchang 334 Hospital from October 2017 to November 2019 were selected as the research subjects.They were divided into the control group and the observation group according to random number table method,with 30 cases in each group.Patients in the control group received non-surgical treatment,and patients in the observation group received stereotactic brain surgery.The dose of clozapine,functional independence measure(FIM)score,gross motor function scale-88(GMFM-88)score,gross motor function scale(GMFCS)score,and Glasgow outcome scale(GOS)classification were compared.Results After six months of treatment,the average daily dose of clozapine in the observation group was lower than that of the control group,and the difference was statistically significant(P<0.05).After six months of treatment,the FIM,GMFM-88,and GMFCS scores were all higher than before treatment in the two groups,and the FIM,GMFM-88,and GMFCS scores of the observation group were higher than those of the control group,and the differences were statistically significant(P<0.05).After six months of treatment,the GOS classification of the observation group was better than that of the control group with statistical significance(P<0.05).Conclusion Patients with refractory psychosis can be treated with stereotactic brain surgery,which can reduce the use of psychotropic drugs,and is conducive to the recovery of patient′s neurological function in a favorable prognosis.

关 键 词：难治性精神病 脑立体定向手术 神经功能 预后 

分 类 号：R651.1[医药卫生—外科学]