胸腔镜下内脏神经切断术治疗肿瘤根治术术后顽固性复发性上腹部癌性痛  

EFFECTS OF THORACOSCOPIC SPLANCHNICECTOMY ON THE TREATMENT OF INTRACTABLE EPIGASTRIC CANCER PAIN AFTER RADICAL CANCER RESECTION

作　　者：陈艾江 杨洪霞[2] 王雁冰[1] 李永犇[1] 

机构地区：[1]河北省保定市第二中心医院胸外科,涿州072750 [2]河北省石家庄市第三医院急救科,石家庄050017

出　　处：《中国疼痛医学杂志》2013年第11期656-658,共3页Chinese Journal of Pain Medicine

摘　　要：目的:探讨胸腔镜下内脏神经切断术对肿瘤根治术术后顽固性复发性上腹部癌性痛的治疗效果。方法:2007年6月至2011年9月期间,13例肿瘤根治术术后顽固性复发性上腹部癌性痛的患者行胸腔镜下内脏神经切断术。记录手术持续时间,术中、术后并发症。观察并记录术前、术后1周、术后1个月、术后3个月的疼痛视觉模拟评分(visual analogue scale,VAS)。记录术后患者住院期间镇痛剂使用情况。结果:平均手术时间35±13.52 min(25～60 min)。术中、术后无明显并发症。与术前相比,术后1周,术后1个月、术后3个月的VAS疼痛评分降低(P<0.05)。术后1周,术后1个月、术后3个月的VAS疼痛评分相比,无统计学差异。术后患者住院期间全部无需阿片类镇痛药物,其中4例患者不需要任何止痛药。结论:胸腔镜下内脏神经切断术治疗肿瘤根治术术后顽固性复发性上腹部癌性痛,手术简单易行、疗效确切,是一种较理想的止痛治疗方法,有良好的临床应用前景,值得推广。Objective： To investigate the therapeutic effects of thoracoscopic splanchnicectomy on the treatment of intractable epigastric cancer pain after radical cancer resection.Methods： From June 2007 to September 2011,13 patients with intractable epigastric cancer pain after radical cancer resection underwent thoracoscopic splanchnicectomy.The operation duration,and the complications during and after the operation were recorded.Pain visual analogue scale（VAS） was recorded before the operation and at the lst week,the1st month,the 3rd month after the operation.The usage of analgesics after the operation was recorded during hospitalization.Results： The duration of the operation was 35±13.52 min（25～60 min）.There was no complication during and after the operation.Compared with before operation,VAS scores were decreased at the lst week,the 1st month,and the 3rd month after the operation.There was no difference in VAS scores among three time points after operation（the lst week,the 1st month,and the 3rd month after the operation）.No opioid analgesic was required for all the patients after the operation during hospitalization and 4 patients did not require any analgesics.Conclusion： The thoracoscopic splanchnicectomy is comparatively effective in the treatment of intractable epigastirc cancer pain after radical cancer resection.This operation is easy to perform with accurate effcacy,which is a promising pain reliving treatment and worth of wide application.

关 键 词：胸腔镜 内脏神经切断术 肿瘤根治术术 

分 类 号：R730.5[医药卫生—肿瘤]