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椎旁神经根毁损治疗恶性肿瘤骨转移截瘫患者顽固性癌痛的临床研究 被引量:3

A Clinical Study of the C-Arm X Ray-Guided Paravertebral Nerve Roots Ne-urolytic Block On The Paraplegic Patients With Refractory Pain Due To Bone Metastasis
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摘要 目的:观察在C形臂引导下行椎旁神经根毁损治疗恶性肿瘤骨转移截瘫患者顽固性癌痛的临床效果。方法:患者俯卧位,选择骨转移截瘫患者疼痛所累及脊神经椎间隙,在C形臂的引导下,行椎旁神经根穿刺,先注入碘海醇3 ml,观察造影剂分布确定针尖邻近神经根,再给予0.5%罗哌卡因3~5 ml,观察15 min,如果疼痛缓解超过50%,给予95%乙醇2~4 ml。记录治疗前、治疗后1天、7天、1个月、2个月患者的VAS评分、吗啡消耗量及可能出现的不良反应。结果:共有15例患者进行了椎旁神经根乙醇毁损治疗,治疗后各时点患者VAS评分及吗啡日消耗量均较治疗前明显降低,所有患者均未观察到严重不良反应。结论:椎旁神经根毁损可以有效缓解恶性肿瘤骨转移截瘫患者的顽固性癌痛,可以作为药物治疗无效者的较佳选择。 Objective: To observe the efficacy of paravertebral nerve roots neurolytic block guided by C-Arm X-ray on the refractory pain due to bone metastasis among paraplegic cancer patients.Methods: All patients were placed in the prone position.Under the guide of C-Arm X ray,the spinal intervertebral space related to the refractory cancer pain was located.3 ml iohexol was injected first to verify the accurate pl-acement of needle,then injected 3 ~ 5 ml 0.5% ropivacaine,if patients reporting more than 50% pain redu-ction after 15 minutes,2 ~ 4 ml 95% alcohol was injected to block the related paravertebral never boots.VAS,daily consumption of morphine and complications were recorded before,1 day,7 days,1 month and 2 months after treatment respectively.Results: 15 patients were enrolled in this study.The VAS and daily consumption of morphine both significantly decreased at each time point after treatment.No complications related to the block were detected.Conclusion: Spinal nerve roots neurolytic block could be a safe and effective choice for the refractory pain of paraplegic patients with bone metastasis,especially for those who suffered uncontrolled pain with drug treatment.
出处 《中国疼痛医学杂志》 CAS CSCD 2011年第12期719-721,共3页 Chinese Journal of Pain Medicine
关键词 神经根毁损 骨转移 截瘫 顽固性癌痛 neurolytic block bone metastasis paraplegia refractory cancer pain
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参考文献8

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同被引文献24

  • 1苏德庆,李江涛,张瑞兰.热疗与放疗骨转移癌性疼痛的近期疗效观察[J].中国肿瘤临床,1996,23(8):598-598. 被引量:4
  • 2Candido KD,Philip CN,Ghaly RF. Transforaminal 5% phenol neurolysis for the treatment of intractable cancer pain[J].Anesthesia and Analgesia,2010.216-219.
  • 3Wagner AL. Selective lumbar nerve root blocks with CT fluoroscopic guidance:technique,results,procedure time,and radiation dose[J].American Journal of Neuroradiology,2004.1592-1594.
  • 4Nakagawa M,Shinbori H,Ohseto K. Ultrasoundguided and fluoroscopy-assisted selective cervical nerve root blocks[J].Masui-Japanese Journal of Anesthesiology,2009.1506-1511.
  • 5Kairaluoma PH,Bachmann MS,Rosenberg PH. Preincisional paravertebral block reduces the prevalence of chronic pain after breast surgery[J].Anesthesia and Analgesia,2006.703-708.
  • 6Yeung AT,Tsou PM. Posterolateral endoscopic excision for lumbar disc herniation:surgcal technique,outcome,and complications in 307 consecutive case[J].Spine,2002.722-731.
  • 7Hoogland T,Schubert M,Miklitz B. Transforaminal posterolateral endoscopic discectomy with or without the combination of a low-dose ehymopapain:a prospective randomized study in 280 consecutive cases[J].Spine,2006.890-897.
  • 8王蕊,冯春美.唑来膦酸注射液治疗骨转移疼痛近期疗效分析[J].中国现代医生,2009,47(15):204-204. 被引量:3
  • 9周跃,李长青,王建,张正丰,初同伟,潘勇,郑文杰,罗刚.椎间孔镜YESS与TESSYS技术治疗腰椎间盘突出症[J].中华骨科杂志,2010,30(3):225-231. 被引量:360
  • 10贾英杰,李小江,陈军,赵成,张蕴超,王琮,孙一予.中医药联合热疗治疗恶性肿瘤的研究现状[J].陕西中医,2010,31(7):931-932. 被引量:5

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