CT引导下阻滞腹腔神经丛治疗顽固性癌痛初探

目的:评价CT引导下阻滞腹腔神经丛治疗顽固性腹部癌痛的临床效果,并对影响止痛效果的因素进行初步探讨。方法:8例腹部癌肿患者,出现顽固性腹痛的时间7-20 d不等,均经临床三级止痛效果不佳而行腹腔神经丛阻滞术。行双侧穿刺者,每侧注入阻滞剂无水乙醇10 m1;单侧者注入无水乙醇15 ml。止痛评分采用1-4分制。通过CT扫描观察阻滞剂分布情况。结果:经术后1周、1个月、2个月、3个月、4个月、5个月、6个月的随访观察,8例中止痛评分≥2分者分别占7例、7例、6例、5例、4例、3例、3例。术后即刻CT扫描显示,8例患者中7例阻滞剂分布良好,1例分布不理想;无一例出现并发症。结论:CT引导下阻滞腹腔神经丛治疗顽固性癌痛,是一种安全而有效的止痛方法,值得推广。

To treat intractable abdominal pain caused by cancer through neurolytic celiac plexus block guided by CT

Objective: To evaluate the therapeutic effect of neurolytic cliac plexus block (NCPB), and analyze the factors related to the pain relief. Methods: Eight patients with intractable abdominal cancer were treated by NCPB. 10ml or 15ml alcohol was injected every side during NCPB. The results of pain relief were classified into four grade. The spread of alcohol was observed through CT scanning. Results :CT scanning showed the spread of alcohol was satisfied in 7 patients after treatment During the follow- up period of 1 week,1 ,2,3,5 and 6 months, the case of pain relief (≥2分) were 7cases, 7 cases、6 cases、5 cases、 4 cases、 3 cases 、3 cases respectively. There were no severe complicatioas in any cases. Conclusions :CT guidance NCPB is an effective and safe means of treating intractable abdominal cancer pain and should be popularized.