加热乙醇腹腔神经丛阻滞治疗上腹部癌痛的临床观察

目的:观察加热乙醇腹腔神经丛阻滞术对晚期癌性上腹痛患者的治疗效果。方法:22例加热组和23例常温组晚期癌性上腹痛患者,CT引导下分别于背侧入路实施经皮穿刺无水乙醇双侧腹腔神经丛阻滞术.止痛效果分为0级～Ⅲ级,分别于术后2周、1个月、2个月、3个月时观察止痛效果。结果:随访观察3个月.治疗后2周、1个月、2个月及3个月时加热组的显效率和有效率显著高于常温组,P<0.05,具有统计学差异。45例中无一例出现严重并发症。结论:加热乙醇腹腔神经丛阻滞乙醇弥散良好,可获得较常温乙醇更好的止痛效果。是一种安全、有效的方法。

Clinical Observation on Upper Adominal Pain Caused by Cancer Neurolytic Celiac plexus Block with hot Alcohol

Objective To study the therapeutic effect for intractable upper abdominal pain caused by cancer after neurolytic celiac plexus block(NCPB)with hot alcohol.Methods Bilateral NCPB with ethanol under CT guidance via posterior approach was performed in 45 patients with intractable upper abdominal pain resulted from malignancies,of which 22 cases hot alcohol group and 23 cases room-temperature alcohol group.The results of pain relief classified 0～Ⅲgrade were evaluated in 2 weeks,1 month,2 months and 3 months.Rosults During the 3 months followup,the excellence rate and overall effective rates pain relief in 2 weeks,1 month,2 months and 3 months were distinctly lower in room-temperature alcohol group than hot alcohol group(P<0.05),there were significant differences between hot alcohol group and room-temperature alcohol group in the ex- cellence rate and total effective rates pain relief.No severe complications occurred in this study.Conclusion NCPB with hot alcohol is an effective and safe modality in the management of intractable pain resulted from advanced abdominal malignancies.