摘要
目的探讨双侧扣带回毁损术治疗海洛因精神依赖的临床疗效和可能的作用机制。方法对4例海洛因成瘾病人术前行美沙酮脱毒治疗;之后采用MRI定位立体定向扣带回毁损术,在双侧扣带回前中1/3交界处射频制造毁损灶;术后进行康复治疗和帮助其回归社会。结果均顺利接受了治疗全过程,无明显并发症。随访半年,2例病人无复吸;1例术后1个月内偶有复吸,其后无复吸;另1例病人术后4个月起复吸。操守较好者焦虑、抑郁等精神症状明显缓解,海洛因渴求程度明显减轻。结论双侧扣带回毁损术治疗海洛因精神依赖,安全、近期有效;可能与精神症状的缓解有关,长期效果有待随访。
Objective To explore the clinical effect and the action mechanism of bilateral sterotactic cingulotomy against strong psychological dependence in heroin addict. Methods After methadone detoxification, the MR image-guided stereotactic cingulotomy was performed, and a lesion was generated bilaterally by thermal coagulation at the boundary between the anterior and middle thirds of the cingulated gyrus in four cases of heroin addicts. Then the rehabilitation regimen was advised before they re-enter the society. Results All the operations were successful, and there is no obvious side effect. Six months follow-up study showed relapse has not occurred in 2 cases, only relapsed in the first month after the operation without following relapse in 1, and relapsed in 1 case after 3-months drug-free time. The patients without relapse felt great relief of anxiety and depression, and the craving for heroin had disappeared. Conclusion Bilateral stereotactic cingulotomy is a safe and effective therapy against strong psychological dependence in heroin addict. It may be owed to the relief of psychotic symptoms. The long-term effect is to be followed up.
出处
《中国微侵袭神经外科杂志》
CAS
2005年第4期162-163,共2页
Chinese Journal of Minimally Invasive Neurosurgery
关键词
扣带回
物质相关性障碍
立体定位技术
戒毒
gyrus cinguli
substance-related disorders
stereotaxic techniques
drug abstinence
