摘要
目的探讨阿片类药物依赖的手术治疗方法,评价其可行性和安全性.方法采用立体定向双侧伏隔核壳部后下部分毁损术治疗35例病人.术后随访36～129 d;对伴发的烟草依赖症状改善情况,手术对睡眠、记忆力、性欲及工作能力的影响,术后不同时间段病人药物渴求程度的改变情况、重新非法用药情况等进行分析.结果该手术具有较高的安全性,可以明显改善大部分病人的睡眠障碍并提高工作能力,不影响性欲和记忆力;在术后不同时间段,病人吸烟量明显降低;阿片类药物渴求显著缓解,完全消除心瘾者27例,占77.1%,重新非法用药者3例,曾1次用药者2例.结论伏隔核毁损术可以有效地消除或部分缓解阿片类药物依赖病人的心理渴求,术后病人保持操守率明显优于常规药物治疗,值得进一步深入探索.
Objective To explore the effective surgery alleviating opiate drug psychological dependence and to evaluate its feasibility and security. Methods Thirty-five patients were treated with stereotactic surgery by ablating the nucleus accumbens bilaterally. Postoperative follow up was 36-129 days. The influences of the surgery on tobacco-dependence symptoms, sleep quality, memory, sexual function and working capacity of these patients were evaluated. Regulation of drug craving and the causes of relapse were analyzed at different postoperative time points. Results After operation, sleep quality and practical working capacity were improved; memory and sexual function were not influenced. Quantity of smoking was clearly reduced and drug craving was alleviated evidently. After surgery, drug psychological dependence in 27 cases was eliminated completely (77.1%); relapse occurred definitely only in 3 cases and dubiously in 2 cases. Conclusion Accumbensotomy can alleviate evidently the drug psychological dependence. Postoperative relapse rate can be clearly reduced and there are no particular complications. This surgery is safe and can be worth further developing.
出处
《中国微侵袭神经外科杂志》
CAS
2005年第2期69-74,共6页
Chinese Journal of Minimally Invasive Neurosurgery
关键词
伏核
隔核
阿片相关性障碍
立体定位技术
nucleus accumbens
septal nuclei
opioid-related disorders
stereotactic techniques
