立体定向双侧多靶点毁损治疗难治性精神分裂症的临床研究

发布时间：2018-07-09 12:55

本文选题：难治性精神分裂症 + 立体定向术　；参考：《山东大学》2012年硕士论文

【摘要】：目的：总结立体定向多靶点射频毁损治疗难治性精神分裂症的手术技巧和经验,并探讨其疗效和安全性。方法：回顾性分析了自2009年6月至2010年8月采用立体定向双侧多靶点射频毁损治疗的115例难治性精神分裂症的临床资料,根据患者的核心症状选择拟毁损靶点,借助Brain Lab手术计划系统将颅脑MR与定位CT图像融合,在脑MRI图像上直接选取拟毁损靶点,通过软件给出相应靶点坐标。对术前、术后患者的简明精神病量表评分及各分项分进行t检验。结果：本组男81例,女34例,年龄18-53岁,平均28.69岁；病程3-30年,平均9.86年。主要临床表现为具有幻觉者88例,妄想93例,敌对、猜疑64例,情感淡漠51例,伴有抑郁症状者32例,伴有强迫症状26例。患者均无自知力,不能参加正常学习、生活及工作。115例患者术后2周,显著进步31例(26.96%),进步84例(73.04%),有效率100%,无严重并发症发生。6个月以上随访恢复14例(12.61%),显著进步66例(59.46%),进步27例(24.32%),无效3例(2.70%),有效率97.30%。术后2周及术后6个月以上简明精神病量表总分及各项分项分在术后显著减低。术后远期并发症2例,小便失禁1例,嗅觉丧失1例。本组无死亡病例。结论：立体定向多靶点射频毁损治疗难治性精神分裂症是一种安全、有效的方法,患者的主要症状及伴随症状均明显缓解,对患者的智力、记忆力、肢体活动无显著影响。
[Abstract]:Objective : To summarize the surgical technique and experience of stereotactic multi - target radiofrequency lesion treatment for refractory schizophrenia , and to discuss its efficacy and safety .

Methods : The clinical data of 115 cases of refractory schizophrenia treated from June 2009 to August 2010 were analyzed retrospectively . According to the core symptom of the patient , the target was selected to be destroyed . The brain MR was fused with the location CT image by the Brain Lab operation planning system , and the corresponding target coordinates were given by software .

Results : 81 male , 34 female , 18 - 53 years old , average 28.69 years old ;
The clinical course was 3 - 30 years , with an average of 9.86 years . The main clinical manifestations were as follows : 88 cases with illusion , 93 cases with delusion , 64 cases of suspicion , 51 cases with depression , 32 cases with depression and 26 cases with obsessive - compulsive symptoms .

Conclusion : Treatment of refractory schizophrenia by stereotactic multi - target radiofrequency ablation is a safe and effective method , and the main symptoms and concomitant symptoms of the patients are obviously relieved , and there is no significant effect on the intelligence , memory and limb activity of the patients .
【学位授予单位】：山东大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R749.3

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