da Costa D A
Faculdade de Ciências, Médicas de Minas Gerais, Belo Horizonte, Brazil.
Schizophr Res. 1997 Dec 19;28(2-3):223-30. doi: 10.1016/s0920-9964(97)00120-5.
Prefrontal lobotomy (i.e. leukotomy) was widely performed for the treatment of schizophrenia during the late 1930s and 1940s but met with growing disrepute after the introduction of effective antipsychotic agents in the early 1950s. While non-invasive methods of treatment are undeniably preferable to somatic interventions for the management of psychiatric illnesses, there nevertheless continues to be a valid role for leukotomy in the treatment of patients with severe, chronic, refractory schizophrenia, particularly when the patient poses a risk to himself and/or to society. The present article traces the history of leukotomy in the treatment of schizophrenia, and reviews the author's experience with this surgical procedure in 16 patients who fulfilled the above criteria and underwent leukotomy during the years spanning 1985 1996. This operation reduced aggression and/or produced marked to slight improvement in all patients, and in no case led to adverse consequences. Thus, leukotomy is recommended as a legitimate treatment modality in selected patients with schizophrenia.
前额叶白质切除术（即脑白质切断术）在20世纪30年代末和40年代被广泛用于治疗精神分裂症，但在20世纪50年代初引入有效的抗精神病药物后，其声誉日益下降。虽然对于精神疾病的管理，非侵入性治疗方法无疑比躯体干预更可取，但脑白质切断术在治疗严重、慢性、难治性精神分裂症患者中仍有其合理作用，特别是当患者对自己和/或社会构成风险时。本文追溯了脑白质切断术治疗精神分裂症的历史，并回顾了作者在1985年至1996年期间对16例符合上述标准并接受脑白质切断术的患者进行该手术的经验。该手术降低了攻击性，和/或使所有患者有显著至轻微的改善，且无一例导致不良后果。因此，推荐脑白质切断术作为特定精神分裂症患者的一种合理治疗方式。
