顽固性疼痛的立体定向治疗  

Stereotactic surgery for intractable pain

作　　者：匡永勤[1] 程林[1] 顾建文[1] 杨涛[1] 孔滨[1] 

机构地区：[1]成都军区总医院神经外科,四川成都610083

出　　处：《实用医院临床杂志》2013年第5期35-37,共3页Practical Journal of Clinical Medicine

摘　　要：目的探讨立体定向靶点毁损手术治疗顽固性疼痛的效果及安全性。方法对4例顽固性疼痛患者，通过cT定位在局麻下进行立体定向靶点毁损手术。手术靶点为双侧中央中核和扣带回，扣带回取两个手术靶点。术后患者给予适当镇静、止血和对症处理。分别于术后1天、7天及3个月进行疼痛状况评分。结果3例患者均感疼痛减轻70％以上，1例患者疼痛消失。术后第1天疼痛VAS评分1—2分3例，0分1例，7天及3月1～2分2例，0分2例。4例患者术后均未再服用止痛药物。2例患者因夜间睡眠不佳，偶有服用镇静药物。4例患者术后疼痛获得明显缓解，心理状态均有一定改善。结论对顽固性疼痛患者在药物作用效果不佳的情况下，采用多靶点立体定向毁损是一种有效、安全、经济的方式。Objective To investigate the surgical outcome of stereotactic lesion for intractable pain. Methods Stereotactic surgery was performed in four patients with intractable pain. The procedure was performed under local anesthesia after CT localization. Surgical targets were bilateral centromedian nucleus and cingulate gyrus. Sedation and symptomatic treatment were performed postopera- tively. Visual analogue scales were investigated on postoperative ! day,7 days and 3 months,respectively. Results Completely relief of pain was achieved in one patient and relief more than 70% were achieved in three patients. On the first day of postoperation, three cases had VAS score 1 -2 points, and one case had 0 point. On the＇ seventh day and in the three months follow-up,two cases had VAS score 1 ~ 2 points and two cases had 0 point. There was no analgesics relapse in the all four patients. Two patients occasionally took antipsy- chotic drugs due to poor sleep at night. Postoperative pain was relieved obviously and mental state was improved in the all four patients. Conclusions For patients with intractable pain, stereotactic surgery is an effective, safe, and economical method for pain relief.

关 键 词：顽固性疼痛 立体定向术 中央中核 扣带回 

分 类 号：R651[医药卫生—外科学]