应用低容量苯酚腹腔神经丛毁损治疗上腹部癌痛  

CT-guided celiac nerve plexus block by using low-volume phenol injection for the treatment of upper abdominal cancerous pain

作　　者：鲁小敏 顾裕平 吴桂鹏 史传岗 LU Xiaomin;GU Yuping;WU Guipeng;SHI Chuangang(Affiliated Hai’an Hospital of Nantong University,Nantong,Jiangsu Province 226600,China)

机构地区：[1]南通大学附属海安医院,江苏226600 [2]海安市肿瘤医院

出　　处：《介入放射学杂志》2021年第11期1166-1169,共4页Journal of Interventional Radiology

摘　　要：目的评估单针低容量苯酚毁损腹腔神经丛治疗上腹部癌性疼痛,为晚期上腹部癌痛患者的治疗提供参考。方法回顾性分析2017年12月到2019年12月147例晚期癌痛患者行CT引导低容量苯酚腹腔神经丛毁损的临床资料。对在CT引导下低容量苯酚行腹腔神经丛毁损前后的疼痛评分、阿片类药物的每日摄入量、肿瘤患者生活质量指数的6个月随访期间的数据进行分析,同时收集手术时间以及与手术相关的并发症发生情况。结果随访期间患者的疼痛评分、每日阿片类药物摄入量和生活质量较术前均得到显著改善(P<0.05)。由于疾病进展,在第4至第6个月疼痛评分有所恢复。9例患者术中发现血管摄取对比剂征象,术后27.2%患者出现了低血压,14.9%患者出现了短暂性的腹泻。所有患者均无腹部灼痛和醉酒征象出现。结论CT引导单针低剂量苯酚用于腹腔神经丛毁损是一种有效、安全且耗时较少缓解上腹部癌痛的方法,可提供长达6个月的疼痛缓解。Objective To evaluate the analgesic effect of CT-guided celiac nerve plexus block by using single-needle low-volume phenol injection in treating upper abdominal cancerous pain so as to provide a reference for the treatment of patients with advanced upper abdominal cancer.Methods The clinical data of 147 patients with advanced cancerous pain,who underwent CT-guided celiac nerve plexus block by using single-needle low-volume phenol injection between December 2017 and December 2019,were retrospectively analyzed.The disease-related data,including the preoperative and postoperative pain scores,the daily intake dose of opioids,the quality of life index of cancer patients and the findings during the 6-month follow-up period were collected and analyzed.The operation-related complications were recorded.Results During the follow-up period,the pain score,the daily intake dose of opioids and the quality of life were significantly improved(P<0.05).Due to the progression of tumor,the pain score became worse within 4-6 weeks after treatment.During the operation,the angiographic signs of tumor staining was observed in 9 patients.After treatment,hypotension occurred in 27.2%of the patients and 14.9%of the patients developed transient diarrhea.No signs of abdominal burning or drunkenness occurred in all patients.Conclusion For the relief of upper abdominal cancerous pain,CT-guided celiac nerve plexus block by using single-needle low-volume phenol injection is a safe,effective and time-saving method,which can relieve cancerous pain for up to six months.

关 键 词：CT引导 苯酚 癌性疼痛 腹腔神经丛 

分 类 号：R730.5[医药卫生—肿瘤]