C型臂CT引导下经皮腹腔神经丛阻滞术在上腹部癌痛中的应用价值  

The application value of C-arm cone-beam CT-guided percutaneous celiac neuroplexus block in treating epigastric cancerous pain

作　　者：孔鹏 苑天文 何阳 王赛博 曹军 KONG Peng;YUAN Tianwen;HE Yang;WANG Saibo;CAO Jun(Department of Oncology Intervention,Dahua Hosptital,Xuhui Disrct,Shanghai 200237,China)

机构地区：[1]上海市徐汇区大华医院介入肿瘤科,200237

出　　处：《介入放射学杂志》2020年第10期1000-1003,共4页Journal of Interventional Radiology

基　　金：上海市卫生健康委先进适宜技术推广项目(2019SY005);上海市医学重点专科建设项目(ZK2019B10)。

摘　　要：目的探讨C臂椎形束CT(CBCT)引导下经皮腹腔神经丛阻滞术在上腹部顽固性癌痛的应用价值。方法将43例均有顽固性上腹痛晚期癌症患者,按患者病例单双号随机分为A、B两组。A组22例行CBCT引导下经皮腹腔神经丛无水乙醇阻滞术,B组21例行常规CT(CCT)引导下经皮腹腔神经丛无水乙醇阻滞术。比较两组手术时间、有效辐射剂量、止痛有效率及并发症。结果A组与B组手术时间分别为(31±11)min、(42±13)min,两组手术时间比较差异有统计学意义(P<0.05)。CBCT组的辐射剂量为(2.9±1.6)mSv,CCT为(4.0±0.7)mSv,两组差异有统计学意义(P<0.05)。两组2周、1个月止痛有效率分别为100%、95.4%,100%、95.2%,两组止痛有效率无明显差别,两组并发症无明显差别。结论CBCT引导下经皮腹腔神经丛阻滞术能有效治疗上腹部顽固性癌痛,能减少手术时间并降低辐射剂量,值得进一步研究和推广。Objective To discuss the application value of C-arm cone-beam CT-guided(CBCT-guided) percutaneous celiac neuroplexus block in treating refractory cancerous pain in the upper abdomen.Methods Forty-three advanced cancer patients with refractory epigastric pain were randomly,according to their number of single or double,divided into group A(n=22)and group B(n=21).Patients in group A received CBCT-guided percutaneous celiac neuroplexus block with injection of ethanol,and patients in group B received conventional CT-guided percutaneous celiac neuroplexus block with injection of ethanol.The time spent for operation,the effective radiation dose,the analgesic effectiveness and the complications were compared between the two groups.Results The time spent for operation in group A and group B were(31±11)min and(42±13)min respectively,the difference in the time spent for operation between the two groups was statistically significant(P<0.05).The radiation dose in group A and group B were(2.9±1.6)mSv and(4.0±0.7)m Sv respectively,the difference in the radiation dose between the two groups was statistically significant(P<0.05).The 2-week and one-month postoperative effective rates of pain relief in group A were100%and 95.4%respectively,which in group B were 100%and 95.2%respectively,the differences between the two groups were not statistically significant.No statistically significant difference in the incidence of complications existed between the two groups.Conclusion CBCT-guided percutaneous celiac neuroplexus block can effectively relieve refractory cancerous pain in the upper abdomen,reduce the time spent for operation as well as the radiation dose.Therefore,this technique is worthy of further research and promotion.(J Intervent Radiol,2020,29:1000-1003)

关 键 词：C臂锥形束CT 经皮腹腔神经丛阻滞术 上腹部顽固性癌痛 

分 类 号：R735.8[医药卫生—肿瘤]