Hussain E S, Freeman H, Jones R A
Greaves Hall Hospital, Southport, UK.
J Neurol Neurosurg Psychiatry. 1988 Mar;51(3):345-52. doi: 10.1136/jnnp.51.3.345.
All cases from an urban population treated by psychosurgery over a 20 year period were followed up; 44 out of 47 were available for study, and 33 of these were interviewed. Outcome was measured on a five-point scale, and follow-up was from 1 to 20 years, with a mean of 11; almost all patients previously had had severe, disabling and intractable illnesses. Operations were non-stereotactic (36), stereotactic (6), with double procedures in one case: outcome was better in the non-stereotactic group. On a five-point scale of outcome, 25 of the 33 interviewed patients were placed in the two best categories, as were eight patients of the 11 who were assessed by case records. Adverse effects were reported in 14 cases, but most were not serious. Only one death could definitely be related to operation. Depression, agoraphobia, obsessional neurosis, and certain aspects of schizophrenia all responded well in the majority of cases. Leucotomy should remain available as a treatment of last resort for some intractable psychiatric disorders.
对城市人口中20年间接受过精神外科治疗的所有病例进行了随访；47例中有44例可供研究，其中33例接受了访谈。结果采用五点量表进行衡量，随访时间为1至20年，平均为11年；几乎所有患者以前都患有严重、致残且难以治疗的疾病。手术方式包括非立体定向手术（36例）、立体定向手术（6例），其中1例进行了两次手术：非立体定向组的结果更好。在五点结果量表上，33例接受访谈的患者中有25例被归入两个最佳类别，11例通过病例记录评估的患者中有8例也是如此。报告了14例不良反应，但大多数并不严重。只有1例死亡肯定与手术有关。在大多数病例中，抑郁症、广场恐惧症、强迫性神经症以及精神分裂症的某些方面对治疗反应良好。白质切断术应作为某些难治性精神障碍的最后治疗手段保留。
