左侧内脏大神经切断术治疗顽固性上腹痛37例临床观察

Clinical evaluation of transhiatal left splanchnicectomy for 37 patient with intractable epigastric pain.

目的 探讨经腹行左侧内脏大神经切断术对顽固性上腹痛的临床治疗效果。方法 1998年 10月至2 0 0 0年 4月共为 37例难治性上腹及腰背痛病人经腹行左侧内脏大神经切断术 ,其中 32例为胰源性疾病 ,余 5例为邻近器官肿瘤。结果 手术前病人疼痛平均为 (9 47± 0 5 5 )分 ,术后平均为 (1 5 3± 1 0 6 )分 ,差异明显 (P <0 0 1)。病人术后住院期间全部无需止痛药物 ,术后随访无疼痛再发。结论 经腹行左侧内脏大神经切断术治疗难治性腹痛 ,疗效确切 ,操作简单 ,并发症少。对于上腹部腹膜后肿瘤引起的难治性疼痛也可以应用此术式治疗。

Objective To investigate the clinical effect of transhiatal left splanchnicectomy for patients with intractable epigastric pain.Methods Transhiatal left splanchnicectomy was performed in 37 patients with intractable epigastric and/or flankpain between 11,1998-4,2000.Of them,32 cases the pain was pancreas origin,the other 5cases were tumor nearly.Results Evaluation of the splanchnicectomy effect clearly demonstrated that the mean postoperative pain score (1.53±1.06) was significantly lower than preoperative pain score (9.47±0.55) (P<0.0001).All patients no longer required postoperative narcotics.Conclusion Transhiatal left splanchnicectomy apperars to be an efficient technique for patients with intractable pain of pancreatic origin as well as other epigastric malignant pain.