单靶点与多靶点联合毁损术治疗阿片类药物成瘾的长期疗效

摘要

Objective To compare the long-term therapeutic effects of stereotactic lesioning of the nucleus accumbens and lesioning of the nucleus accumbens combined with others targets for opiate addiction. Methods Seventy-five patients were selected randomly and equally from patients with opiate addiction of two groups who underwent stereotactic lesioning of the bilateral nucleus accumbens (single-target group) and iesioning of the bilateral nucleus accumbens combined with others targets (multi-target group) respectively in 7 medical centers of China. The retrospective follow-up research 5 years after the operation was executed to compare the rate of relapse and incidence rate of side effects between the two groups. Results Sixty-two patients in single-target group and 60 ones in multi-target group received and completed the follow-up. There was no a significant difference between relapse rate and incidence of non-specific side reaction in the two groups (P=0.678, P=0.780 respectively). The incidence rate and severity of specific side reaction in multi-target group were higher than those in single-target group (P=0.011, P=0.008 respectively). Conclusions Compared with stereotactic lesioning of the nucleus accumbens, there is no decrease in the relapse rate after combined lesioning of the nucleus accumbens with others targets for opiate addiction, but side reaction rate increases significantly.%目的 比较伏隔核损毁术与伏隔核加其他靶点联合损毁术治疗阿片类药物成瘾的长期疗效.方法 从我国7个医疗中心接受过双侧伏隔核毁损术(单靶点)与双侧伏隔核加其他靶点联合毁损术(多靶点)治疗阿片类药物成瘾的两组病人中分别随机抽取75名病人,术后第5年回顾性随访研究,比较两组的复吸率和副反应发生率.结果 单靶点组和多靶点组各有62例和60例病人接受并按计划完成随访.两组间复吸率和非特异性副反应的病人比例差异均无统计学意义(P=0.678,P=0.780).多靶点组特异性副反应的比例与严重程度均高于单靶点组,差异有统计学意义(P=0.011,P=0.008).结论 与立体定向伏隔核单靶点损毁术相比,伏隔核加其他靶点联合损毁术治疗阿片类药物成瘾的复吸率未降低,但特异性副反应发生率明显增高.