内镜超声引导下腹腔神经丛阻滞术治疗晚期胰腺癌疼痛29例分析  

Therapeutic value of endoscopic ultrasound-guided celiac plexus neurolysis for pain associated with advanced pancreatic carcinoma in 29 patients

作　　者：楼颂梅[1] 张筱凤[1] 黄海涛[1] 吕文[1] 杨建峰[1] 

机构地区：[1]杭州市第一人民医院消化内科,310006

出　　处：《中华消化内镜杂志》2017年第9期658-661,共4页Chinese Journal of Digestive Endoscopy

摘　　要：目的分析内镜超声引导下腹腔神经丛阻滞术（EUS—CPN）治疗晚期胰腺癌患者顽固性疼痛的临床疗效。方法回顾性分析2010年5月至2015年4月在杭州市第一人民医院行EUS—CPN的29例胰腺癌患者临床资料，采用疼痛视觉模拟评分（VAS）评估患者治疗前后的疼痛情况，采用疼痛缓解度（PAR）评价该术式的临床疗效。结果29例患者成功实施EUS—CPN。术前所有患者平均VAS值为8．2±2．3，治疗后次日为3．6±1．5，较术前显著下降（P=0．00）；术后1个月平均VAS值为2．0-0．6，与术后次日相比差异有统计学意义（P=0．00）。术后1个月，10例患者疼痛完全缓解，9例明显缓解，4例中度缓解，3例轻度缓解，3例未见缓解，疼痛缓解有效率为79．3％（23／29）。结论EUS—CPN可有效控制胰腺癌患者的疼痛，减少疼痛对患者的不良影响，提高患者生活质量。Objective To evaluate the clinical efficiency of endoscopic ultrasound-guided celiac plexus neurolysis （EUS-CPN） for pain associated with advanced pancreatic carcinoma. Methods EUS-CPN was performed in 29 patients with advanced pancreatic carcinoma in Hangzhou First People＇s Hospital from May 2010 to April 2015. The pain status before and after treatment was measured by visual analogue scale （VAS）, and the clinical efficacy was assessed by pain anesis rate （PAR）. Results All the 29 patients successfully completed EUS-CPN. The mean VAS value of the first day after treatment （ 3.6± 1.5 ） was lower than that of preoperative （8.2±2. 3, P=0. 00）. The mean VAS value of 1 month after treatment （2. 0±0. 6） was statistically different compared with the value of the first day after treatment （P= 0. 00）. There were 10, 9, 4, and 3 patients who had complete, obvious, moderate and mild relief, respectively. Three patients had no pain relief. The overall efficiency rate was 79. 3% （23/29）. Conclusion EUS-CPN is a safe and effective method for relieving pain in pancreatic carcinoma.

关 键 词：胰腺肿瘤 内镜超声检查 腹腔神经丛阻滞术 镇痛 

分 类 号：R735.9[医药卫生—肿瘤]