CT引导下穿入淋巴结内无水乙醇腹腔神经丛阻滞术治疗顽固性癌性腹痛  

CT-guided percutaneous ethanol nerve block therapy of celiac plexus embedded in metastatic lymph nodes for the treatment of intractable carcinomatous abdominal pain

作　　者：席芊[1] 王培军[1] 尚鸣异[1] 马骏[1] 陆影[1] 黄宗良[1] 唐俊军[1] 高晓龙[1] 

机构地区：[1]上海同济大学附属同济医院放射科,200065

出　　处：《介入放射学杂志》2010年第5期386-388,共3页Journal of Interventional Radiology

摘　　要：目的评价CT引导下经皮穿入淋巴结内腹腔神经丛阻滞术对伴有后腹膜淋巴结广泛肿大、融合,并侵犯、包裹腹腔神经丛的顽固性癌性腹痛的止痛效果。方法 104例晚期癌症患者,均有严重的上腹部疼痛、伴有后腹膜淋巴结广泛肿大,并融合成团块状。采用过麻醉类止痛药治疗,效果均不佳。应用CT引导下穿入淋巴结内无水乙醇阻滞方法进行治疗。结果治疗后即刻,2周,1、2、3和4个月的止痛有效率分别为100%、100%、100%、98.0%、96.9%、92.6%。围手术期无严重并发症,治疗后生活质量明显改善。结论对伴有后腹膜淋巴结广泛肿大,融合成块,并侵犯、包裹腹腔神经丛的顽固性癌性腹痛患者,采用穿入淋巴结内阻滞疗法,可取得较好的止痛治疗效果,具有较高的临床价值。Objective To evaluate CT-guided percutaneous ethanol nerve block therapy of celiac plexus embedded in metastatic lymph nodes in treating intractable carcinomatous abdominal pain. Methods A total of 104 patients with late stage cancers were enrolled in this study. All patients suffered from serious carcinomatous pain at upper abdomen and their retroperitoneal lymph nodes were extensively enlarged and fused, together with the involved celiac plexus, into a hard crumb. As the patients failed to respond to narcotic analgesics CT-guided ethanol nerve block therapy of celiac plexus was carried out by pushing the puncture needle through the fused lymphatic mass to celiac plexus site. The analgesic effects and complications were observed and the therapeutic results were evaluated. Results The analgesic effective rate of ethanol nerve block therapy immediately after the procedure was 100%, and at 2 weeks, 1, 2, 3 and 4 months after the treatment it was 100%, 100%, 98.0%, 96.9% and 92.6%, respectively. No serious complications occurred during perioperative period. The living quality was markedly improved in all patients. Conclusion For the treatment of intractable carcinomatous abdominal pain in patients with their celiac plexus being embedded in mass-like metastatic retroperitoneal lymph nodes CT-guided percutaneous ethanol nerve block therapy by pushing the puncture needle through the fused lymphatic mass to celiac plexus site is of great clinical value in relieving carcinomatous abdominal pain.

关 键 词：疼痛 顽固性 无水乙醇 腹腔神经丛 阻滞 淋巴结 

分 类 号：R730.5[医药卫生—肿瘤]