化学性腰交感神经切除术对下肢顽固性痛的镇痛效果

Analgesic effects of chemical lumbar sympathectomy on refractory pain in the lower limbs

目的评估化学性腰交感神经切除术对下肢痛的镇痛效果。方法选择下肢顽固性痛患者24例,在X线引导穿刺腰2椎体前缘的下1/3处,经造影剂和局麻药测试安全有效后,使用7%苯酚进行腰2交感神经节区域化学切除手术。观察患者化学性腰交感神经切除术的镇痛效果。患者口服镇痛的效果作为对照,将术前口服镇痛药效果与术后效果进行自身比较。结果患者下肢疼痛症状明显减轻,镇痛效果明确,化学性腰交感神经切除术的镇痛效果明显优于口服镇痛药(P<0.05)。结论化学性腰交感神经切除术对于下肢顽固性痛具有明确镇痛作用。

Objective To evaluate the effect of chemical lumbar sympathectomy （CLS） on relieving refractory pain in the lower limbs. Methods Twenty-four patients with refractory pain in the lower limbs underwent CLS under X-ray guidance, and 2 ml contrast agent was injected at 1/3 of the second Lz vertebrae （the L2 sympathetic ganglion）. Lidocaine was then injected followed by injection of 7% phenol for performing CLS. The visual analog scale was used to assess the pain severity before and after CLS. The effect of CLS on relieving lower limb pain was compared with that of oral pain-relieving medication. Results The lower limb pain was obviously relieved as shown by significantly decreased VAS scores in these patients after CLS. CLS exhibited a much more potent effect of pain relief in the lower limbs than the oral medication. Conclusion CLS produces significant analgesic effects to relieve refxactory pain in the lower limbs