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双边前部囊切除术用于治疗抗性强迫症

Trevor Hurwitz¹, Geoffrey Ching¹, Nicholas Mark Bogod²

¹Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada.

Stereotactic and functional neurosurgery

|August 25, 2024

概括

双边前囊切除术 (BAC) 是治疗耐药强迫症 (TROCD) 的有效最后手段,在一项20年研究中,症状持续减轻,没有显著的长期副作用.

科学领域:

神经外科神经外科
精神病学是一个精神病学.
神经学神经学

背景情况:

废除性手术,特别是双边前囊切除术 (BAC),是严重的,耐治疗的强迫症障碍 (TROCD) 的最终治疗选择.
我们的中心已经为符合条件的患者使用BAC二十年了,需要对长期结果进行审查.

研究的目的:

报告双边前囊切除术 (BAC) 在耐治疗强迫症障碍 (TROCD) 患者的长期疗效和安全性.
评估经过BAC手术后的持续反应率和潜在的神经认知或身体副作用.

主要方法:

五名患有强迫症 (OCD) 的患者符合BAC的标准,使用立体无线电频率进行了手术.
遵循复杂的入口协议,并在手术后4至20年内监测患者.
在冠状平面上,损伤大小从5.7mm到16.9mm不等.

主要成果:

所有五名患者 (100%) 均实现了应答者状态,定义为18个月后耶鲁-布朗强迫强迫 (YBOCS) 评分下降≥35%.
在48个月后的4名患者中,症状的减缓持续了48个月,在药物停用后的19年后发生了一次复发.
没有观察到任何显著的长期神经认知或身体副作用;然而,现实世界的精神病学结果各不相同.

结论:

双边前囊切除术 (BAC) 应作为对其他治疗无反应的严重强迫症病例的可行的最后手段.
该程序在经过精心挑选的患者中证明了长期的疗效和有利的安全性.

关键词:

前部囊切除术 (anterior capsulotomy) 是一个前部囊切除术.功能神经外科手术功能神经外科强迫症是一种强迫症.心理外科心理外科立体外科手术是一种整形手术.

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