腹腔神经丛阻滞治疗晚期癌症患者腹膜后淋巴结转移顽固性上腹痛的疗效

Effect of Coelial Plexus Blockage on Refractory Upper Abdominal Pain with Retroperitoneal Lymph Node Metastasis

【目的】评价CT导引下后路穿刺腹腔神经丛淋巴结内及腹膜后间隙腹腔神经丛阻滞术对晚期癌症患者腹膜后淋巴结转移顽固性上腹痛的止痛效果。【方法】对17例CT增强扫描均有胰腺后方腹膜后广泛淋巴结转移,顽固性上腹痛,采用麻醉类止痛效疗不佳的晚期癌症患者,应用CT导引经皮穿刺淋巴结内及腹膜后间隙无水酒精注射阻滞腹腔神经丛方法治疗。【结果】治疗后疼痛完全消除9例(52.9%)。疼痛较前显著减轻5例(29.4%)。疼痛较前减轻,但仍依赖麻醉类药物方能控制疼痛3例(17.7%)。但所有患者生存质量获得提高,无严重并发症发生。【结论】对晚期癌症腹膜后淋巴结转移顽固性上腹痛患者,经本方法能有效地阻滞腹腔神经丛取得良好的止痛效果。提高生存质量,并能获得淋巴结消融的近期疗效。该方法安全、实用。

[Objective]To evaluate the analgesic effect of CT-guided coelial plexus blockage on refractory upper abdominal pain with retroperitoneal lymph node metastasis. [Methods]Seventeen advanced cancer patients with extensive retroperitoneal lymph node metastasis and refractory upper abdominal pain were treated with percutaneous CT- guided coelial plexus blockage with absolute alcohol. [Results] Nine cases had complete elimination of pain（52.9%）, 5 cases had significant relieve（29.4%） and 3 cases had better than before, but still necessary dope（17.7%）. All patients had no severe complications and had improved their quality of life. [Conclusion]The advanced cancer patients who have refractory upper abdominal pain and extensive retroperitoneal lymph node metastasis, have significant effect to relieve pain through coelial plexus blockage. It can improve their quality of life and obtain the effect in the future with absorbent ablation. This method is safety and practical.