腹腔神经丛阻滞术治疗上腹部顽固性癌性疼痛  

Controlling intractable upper abdominal pain caused by cancer through neurolytic celiac plexus block

作　　者：刘江泽[1] 李英[1] 易长虹[1] 王光亚[1] 谢孝平[1] 

机构地区：[1]湖北省荆州市中心医院影像中心,湖北荆州434020

出　　处：《中国介入影像与治疗学》2005年第2期127-129,共3页Chinese Journal of Interventional Imaging and Therapy

摘　　要：　目的　评价腹腔神经丛阻滞术治疗上腹部顽固性癌性疼痛的止痛效果。方法　105 例晚期癌症患者,67 例伴有后腹膜淋巴结广泛肿大并包绕神经、血管,均有顽固性上腹痛,经CT导引穿入隔脚前及后腹膜肿大淋巴结内行两侧腹腔神经丛无水乙醇阻滞术。结果　经 4 个月随访观察,在 2 周、1 个月、2 个月、3 个月、4 个月,止痛总有效率分别为100%、98.09%、97.05%、93.81%、90.42%。在止痛效果显著者,可观察到无水乙醇扩散较完全,能从两侧包绕腹主动脉,肿大的淋巴结有明显坏死。本组无严重并发症。结论　CT导引下腹腔神经丛阻滞术治疗上腹部顽固性癌性疼痛是一种安全、有效的方法,应推广应用。Objective To evaluate the therapeutic effect of neurolytic celiac plexus block (NCPB) with intractable upper abdominal pain caused by cancer. Methods A total of 105 later periods cancer sufferer who had intractable upper abdominal pain were included, in which 67 accompanied with extensive retroperitoneal lymph nodes and celiac plexus involvement fusing masses. Ethanol was injected through neurolytic celiac plexus block with the needle tip positioned into masses fused by lymph nodes. Restlus During the 4 months follow-up, the total effective rates of pain relief in 2 weeks, 1 month, 2 months, 3 months and 4 months were 100%, 98.09%, 97.05%, 93.81% and 90.42%, respectively. Satisfactory pain relief results were obtained when the neurolytic solution encircled the aorta adequately from two sides. The tumorous retroperitoneal lymph nodes shrank markedly with severe necrosis. There were no severe complications in any case. Conclusion NCPB guided by CT proves is an effective and safe means of controlling intractable upper abdominal cancer pain and should be popularized.

关 键 词：上腹部顽固性癌性疼痛 腹腔神经丛阻滞术 治疗 晚期癌症患者 顽固性上腹痛 止痛效果 无水乙醇 CT导引 腹膜淋巴结 肿大淋巴结 严重并发症 随访观察 总有效率 腹主动脉 推广应用 后腹膜 两侧 

分 类 号：R735[医药卫生—肿瘤]