Kelly D, Mitchell-Heggs N
Postgrad Med J. 1973 Dec;49(578):865-82. doi: 10.1136/pgmj.49.578.865.
This prospective study reports the results of stereotactic limbic leucotomy at a mean of 17 months following surgery. Clinical improvement had occurred in twenty-four (80%) of the patients, fifteen (50%) of them being symptom free or much improved. Fourteen of sixteen patients suffering from obsessional neurosis were improved, as were five of seven with chronic anxiety and the degree of improvement at 17 months was superior to that at 6 weeks. Psychometric scores of anxiety, obsessions and neuroticism were all significantly reduced at 17 months. The mean depression scores were also significantly reduced and this result was superior to that reported in a previous study of ‘free-hand’ operations. Adverse effects were not a problem following limbic leucotomy. Emotional blunting, disinhibition, post-operative epilepsy and excessive weight gain were not encountered, and intelligence was unaffected by the operation. Limbic leucotomy is a much more limited and precise procedure than older ‘free-hand’ operations which we have studied, but its therapeutic effects are comparable and in obsessional neurosis, superior.
这项前瞻性研究报告了立体定向边缘白质切断术术后平均17个月的结果。24名（80%）患者出现了临床改善，其中15名（50%）患者症状消失或有显著改善。16名患有强迫性神经症的患者中有14名病情得到改善，7名患有慢性焦虑症的患者中有5名病情得到改善，且17个月时的改善程度优于6周时。17个月时，焦虑、强迫观念和神经质的心理测量分数均显著降低。平均抑郁分数也显著降低，这一结果优于先前一项关于“徒手”手术的研究报告。边缘白质切断术后不存在不良反应问题。未出现情感迟钝、去抑制、术后癫痫和体重过度增加的情况，手术也未影响智力。与我们研究过的较旧的“徒手”手术相比，边缘白质切断术是一种更有限且精确的手术，但它的治疗效果相当，在治疗强迫性神经症方面更具优势。
