CAJ | 학술논문

目的探讨立体定向下多靶点毁损手术对老年期痴呆合并精神障碍患者精神症状的改善及智力状况的影响.方法在CT定位下,应用脑立体定向技术对18例病人进行颅内多靶点毁损治疗.按全国精神外科协作组织于1990年制定的评定方法及量表进行疗效评定.结果 18例患者术后随访12～36个月,精神测评结果:显著进步9例,进步6例,无效3例,有效率83.3%,术后简明精神病评定量表(BPRS)、社会功能量表(SDSS)、阳性症状量表(SAPS)评分较术前均明显降低,差异有统计学意义(P＜0.05);而术后简易智力状况检查(MMSE)与术前比较统差异无统计学意义(P＞0.05).结论立体定向下多靶点毁损术是治疗老年期痴呆所致严重精神障碍有效方法,且并发症少,对患者智力无影响.
목적 탐토입체정향하다파점훼손수술대노년기치태합병정신장애환자정신증상적개선급지력상황적영향.방법 재CT정위하,응용뇌입체정향기술대18례병인진행로내다파점훼손치료.안전국정신외과협작조직우1990년제정적평정방법급량표진행료효평정.결과 18례환자술후수방12～36개월,정신측평결과:현저진보9례,진보6례,무효3례,유효솔83.3%,술후간명정신병평정량표(BPRS)、사회공능량표(SDSS)、양성증상량표(SAPS)평분교술전균명현강저,차이유통계학의의(P＜0.05);이술후간역지력상황검사(MMSE)여술전비교통차이무통계학의의(P＞0.05).결론 입체정향하다파점훼손술시치료노년기치태소치엄중정신장애유효방법,차병발증소,대환자지력무영향.
Objective To explore the clinical effects of stereotactic radiofrequency multitarget lesion on the treatment of senile dementia in patients with mental disorder. Methods Under the CT localization, 18 patients with mental retardation were treated by stereotactic surgery of multi-target lesion.Their therapeutic effects were evaluated by Scale and National Psychosurgery Cooperation Request on Modern Psychosurgery Operation Cure (protocol) in 1990. Results Postoperative follow-up was performed for 12-36 months; 9 patients progressed remarkably; 6 got improvement and only 3 showed no changes; the total effective rate was 83.3%. The scores of brief psychiatric rating scale, social disability screening schedule and scale for assessment of positive symptoms after the treatment were significantly lower than those before the treatment (P＜0.05). Mini-mental state examination showed no changes on the intelligence before and after the treatment (P＞0.05). Conclusion The stereotactic surgery of multi-targets lesion is an effective method in treating senile dementia in patients with mental disorder,with few complications and little influences on the intelligence.