内镜超声无水酒精注射腹腔神经丛治疗上腹部癌痛  

Endoscopic ultrasound guided celiac plexus neurolysis for upper abdominal cancer pain

作　　者：杨秀疆[1] 刘苏[1] 谢渭芬[1] 陈伟忠[1] 沈建伟[1] 

机构地区：[1]第二军医大学长征医院消化内科,上海200003

出　　处：《胰腺病学》2003年第3期145-148,共4页Chinese JOurnal of Pancreatology

摘　　要：目的　探讨内镜超声 (EU S)引导下腹腔神经丛注射无水酒精对癌痛的治疗作用。方法　选择癌痛病例记录疼痛分数并随访 ,用纵轴式彩色 EUS显示腹主动脉第一分支 ,在其两侧注射无水酒精。结果　 10例胰腺癌 ,1例胆囊癌 ,1例胃癌。全部病例均有转移征象。注射前疼痛分数 (0 ～ 10分级 )为 :胰腺癌 6 .7± 0 .3、胆囊癌 5 .9、胃癌 6 .0 ;注射后 12周为胰腺癌 1.2 ± 1.0、胆囊癌 1.3、胃癌 1.5。并发症 :8例注射后发生体位性低血压 ,6例出现腹泻 ,3例出现注射部位轻微渗血 ,用镜身压迫止血。全部病例无感染及穿孔发生。结论　 EUS引导下腹腔神经丛注射能够安全有效缓解腹腔内癌痛。Objective To evaluate the safety and efficacy of endosonography-guided celiac plexus neurolysis (EUS CPN) for analgesia of cancerous pain of the upper abdomen. Methods Included in this study were 10 patients with pancreatic carcinoma, one patient with gallbladder carcinoma and one patient with gastric carcinoma. Using a linear array ultrasound endoscope and a needle catheter, transgastric injection of the celiac plexus with bupivacaine and 98% dehydrated absolute alcohol was performed. Results The pain scores for pancreatic carcinoma, gallbladder carcinoma and gastric carcinoma were 6.7 ± 0.3, 5.9 and 6.0 respectively before CPN, and decreased to 1.2 ± 1.0, 1.3 and 1.5 at 12 weeks of EUS CPN treatment. Complications included orthostatic hypertension in 8 patients, diarrhea in 6 patients, and oozing at the site of injection in 3 patients, which was stopped by compression. Conclusions EUS CPN is a safe and effective means of relieving pain from intra-abdominal malignancies.

关 键 词：内镜超声 无水酒精注射 腹腔神经丛治疗 上腹部癌痛 胰腺肿瘤 

分 类 号：R735[医药卫生—肿瘤]