超声介入腹腔神经节毁损治疗胰腺癌疼痛(英文)

Analgesia on pancreatic carcinoma with chemical destruction of celiac ganglion by ultrasonic intervention

目的探讨超声介导腹腔神经节毁损对胰腺癌痛患者的治疗作用。方法97例胰腺癌痛患者采用B超引导经皮穿刺,于腹腔动脉干根部旁侧注入无水乙醇15mL,实施腹腔神经节化学性毁损。对比观察治疗前后疼痛的视觉模拟评分(VAS)、血清SP和β-EP以及T细胞亚群水平变化。结果97例中仅1例穿刺失败,成功率98.7%,无严重并发症;VAS、血清SP和β-EP与术前差异有显著性(P<0.01,P<0.05,P<0.01);疼痛完全缓解率54.2%,部分缓解率21.9%,轻度缓解11.4%,无效12.5%,疼痛复发率仅10.7%,生存质量明显提高;与疼痛治疗前相比,胰腺癌痛患者的淋巴细胞T亚群水平显著上升(P<0.01)。结论该微创技术具有很高的安全性,能显著减轻胰腺癌性疼痛并提高细胞免疫水平。

[ Objective ] To detect the therapeutic effects of chemical destruction of celiac ganglion on patients with pancreatic carcinoma with intractable pain. [Methods] 97 cases with advanced pancreatic carcinoma accepted chemical destruction of celiac ganglion 15 mL pure alcohol injection around celiac artery by ultrasonic intervention. The varieties of VAS, serum SP, β-EP and T-lymphocyte subtypes level were compared between pre- and post-therapy. [Results] Successful rate of puncture was 98.7%, with 1 loss. No serious complications such as traumatic pancreatitis, pancreatic fistula, abdominal cavity hemorrhage or peritoneal infection in this study. VAS, serum SP and β-EP level significantly changed after treatment（P 〈0.01, P 〈 0.05 and P 〈0.01）, with complete relief rate 54.2%, partial relief rate 21.9%, inefficient rate12.5% and recurrent rate only 10.7%. The T-lymphocyte subtypes level remarkably increased when compared with that of pre-therapy （P 〈0.01）. [Conclusion] This study suggests that chemical destruction of celiac ganglion by ultrasonic intervention proves to be highly safe, and can evidently relieve cancer pain of pancreas and improve the cellular immune level on patients with advanced pancreatic carcinoma.