摘要
目的:探讨多靶点联合射频毁损治疗难治性抽动-秽语综合征(TS)的长期疗效。方法:回顾性分析2007年11月至2015年5月间解放军第458医院神经外科采用多靶点射频毁损术治疗难治性TS的13例患者的临床资料。术中根据立体定向选择右侧苍白球、丘脑VIM核、双侧杏仁核、内囊前肢及扣带回为联合靶点;并在术前、术后对患者应用耶鲁综合抽动严重程度量表(YGTSS)进行评分,包括运动抽动评分及发声抽动评分。结果:13例患者随访时间为3~18月,平均13.5月。12例患者术后抽动症状较前明显改善;按YGTSS评分标准,优良12例,差1例,优良率为92.3%;与术前比较,差异具有统计学意义(P<0.01),所有患者无严重并发症和后遗症。结论:以右侧苍白球、丘脑VIM核、双侧杏仁核、内囊前肢及扣带回为联合靶点的射频毁损术是治疗难治性TS的安全有效方法。
Objective To evaluate the long-term therapeutic effect of treatment-refractory Tourette＇s syndrome（TS） treated with multi-target radiofrequency ablation. Methods The clinical data of 13 patients receiving multi-target radiofrequency blation for treatment-refractory TS selected from patients admitted to 458 Hospital of PLA between November 2007 and May 2015 were retrospectively analyzed. The right globus pallidus, VIM thalamic nucleus, bilateral amygdala, cingulate gyrus and anterior limb were selected as targets in operation. Before and after the operation, Yale Global Tic Severity Scale（YGTSS） was used to evaluate the global tic severity of patients, scoring motor tics and vocal tics. Results The average follow-up time was 13.5 months（3-18 months）. After the operation, the symptoms were obviously improved in 12 patients. All the patients underwent the operation successfully, without developing any severe complications and sequelae. The postoperative YGTSS scores of motor tics and phonic tics shows excellent in 12 cases and poor in 1 case, with an excellent rate of 92.3%. Statistical differences were found in YGTSS scores before and after operation（P〈0.01）. Conclusion Multiple-target radiofrequency ablation with the right globus pallidus,VIM thalamic nucleus, bilateral amygdala, cingulate gyrus and anterior limb as targets is a safe and effective therapeutic approach to treatment-refractory TS.
作者
周连银
汪鲁刚
唐运林
林冬
徐越
张奕生
宋志军
李华雨
ZHOU Lianyin WANG Lugang TANG Yunlin LIN Dong XU Yue ZHANG Yisheng SONG Zhijun LI Huayu(Department of Neurosurgery, 458 Hospital of PLA. Guangzhou 510602, China Department of Medical Imaging, 458 Hospital of PLA, Guangzhou 510602, China)
出处
《中国医学物理学杂志》
CSCD
2017年第10期1078-1080,共3页
Chinese Journal of Medical Physics
