| Objective To summarize the operation skills, experience, treatment effect and safety of stereotactic radiofrequency thermocoagulation (SRT) with bilateral multiple targets for intractable schizophrenia (IS).Methods The clinical data of115cases with IS treated by SRT with bilateral multiple targets were analyzed retrospectively between June2009and August2010. The targets were determined according to the patient’s core symptoms. The brain MRI images were integrated with CT images by BrainLab operation planning system and the plan targets could be selected directly on the brain MRI images. The efficacy evaluation and Scale evaluation were made by psychiatrists and neurosurgeons together before operation, two weeks and over six months after operation. The coordinates of targets could be provided by the software. The total scores and each score of pre-and post-operative Concise Psychiatric Rating Scale (CPRS) were analyzed with t-test.Results There were81males and34females with the average age of28.69years old (from18to53) in this group. Their ill courses were between3and30years (mean9.86years). The patients were mainly manifested as hallucination in88cases, delusion in93cases, hostile and suspicion in64cases, apathy in51cases. Accompanied by depressive symptoms in32cases, obsessive-compulsive symptoms in26cases, all patients have no insight and ability to participate in the normal study, life and work. It was found that there was remarkable progress in31cases (26.96%),84cases improved (73.04%), no serious complications and with an effective rate of100%2weeks after operation in this series. The follow-up of over six months showed complete recovery in14cases (12.61%), significant improvement in66(59.46%), improvement in27(24.32%) and no effect in3(2.70%), with a total effective rate of97.3%. On the whole, both total scores and each item score of CPRS decreased significantly after2weeks and6months after operation. Postoperative long-term complications happened in two cases (urinary incontinence and olfactory loss respectively in1case). No deaths occurred in this group.Conclusion SRT with bilateral multiple targets for IS is a safe, effective treatment method, which can relieved markedly the patients’main and accompanied symptoms except of intelligence, memory and physical activity. |
