中脑加扣带回联合毁损术治疗顽固性疼痛效果观察  

Cooperation of mesencephalotomy and bilateral anterior cingulotomy for the treament of intractable pain

作　　者：沈旭辉[1] 刘会[1] 王天成[1] 

机构地区：[1]辽宁省人民医院神经外科,辽宁沈阳110016

出　　处：《中国现代医药杂志》2013年第6期56-57,共2页Modern Medicine Journal of China

摘　　要：目的研究颅内核团联合毁损术治疗各种顽固性疼痛的临床应用。方法顽固性疼痛5例,包括鼻咽癌3例,丘脑出血1例,脊髓损伤1例,局麻下联合毁损疼痛对侧中脑传导束和双侧扣带回前部,采用直观模拟疼痛量表(VAS)和McGill疼痛问卷量表(MPQ)评分方法,对每例患者术前和术后不同时期的疼痛状况进行评分,通过小样本自身配对t检验将患者术后不同时期的VAS、MPQ评分与术前的评分进行比较。结果每例患者术后疼痛基本消失,停止使用止痛药物。随访术后6个月疼痛没有反复,VAS评分、MPQ评分与术前相比明显降低(P<0.01),无严重并发症发生。结论中脑加扣带回联合毁损术能有效消除顽固性疼痛。Objective To study the clinical application of the cooperation of intracranial nucleus for the treatment of various intractable pain. Methods Five patients with intractable pain,including 3 cases of nasopharyngeal cancer,1 case of thalamic hemorrhage,1 case of spinal cord injury,were treated by the cooperation of midbrain conduction tract contrary to pain and bilateral anterior cingulotomy with local anesthesia. The visual analog scale （VAS） and the McGill pain questionnaire （MPQ） were used for preoperative and postoperative evaluation for the pain status of each patient. Compared preoperative and postoperative scores of VAS and MPQ through the small self-paired-sample t test. Results Each patient’s pain disappeared partly after operation and stopped using painkillers. The results of postoperative 6-month follow-up indicated that pain wasn’t repeated ,a significant reduction in VAS and MPQ comparing with preoperative scores （P＆lt;0.01）. There were no serious complications. Conclusion The cooperation of mesencephalotomy and bilateral anterior cingulotomy is an effective means for relieving intractable pain.

关 键 词：扣带回毁损术 中脑毁损术 顽固性疼痛 

分 类 号：R402[医药卫生—临床医学]