肝癌射频消融术前指标对术后疼痛的预测价值

The predictive value of preoperative indexes of radiofrequency ablation for postoperative pain

目的 探讨肝癌射频消融术前指标对术后疼痛的预测价值。方法 80例患者中28例病灶临近肝包膜,52例病灶远离肝包膜。原发肝癌39例,继发肝癌41例,病灶较大径（7~43mm）。术后采用视觉模拟评分法（VAS）对患者疼痛程度进行评估。结果 80例患者于全麻下接受超声引导射频消融治疗并获取术后VAS评分（0~4分）。病灶临近肝包膜、直径较大的患者,术后痛觉更明显,病灶较大径、病灶与肝包膜最短的距离与VAS评分具有显著相关性,P〈0.01,患者年龄、肿瘤来源与VAS评分不具有相关性,P〉0.05。结论 全麻下超声引导射频消融治疗后,病灶较大、临近肝包膜者更易疼痛。

Objective To explore the predictive value of preoperative indexes of radiofrequency ablation for postoperative pain. Methods The present study enrolled 80 patients including 57 males and 23 females. According to the distance that focus located far from liver capsule or near the capsule, those patients were categorized into two groups ： in group 1, there were 28 pa- tents, with the foci near liver capsule and in group 2, there 52 patients, with loci far from the capsule. There were thirty-nine pa- tients with primary liver cancer and forty-one patients with secondary liver cancer, with lager focus diameters（ ranged from 7to 43 ram）. The degree of the pain after ultrasound-guided percutaneous radiofrequency ablation was valued using visual analog scale （VAS）. Results Eighty patients were received ultrasound-guided percutaneous RFA under general anesthesia and VAS scores of the patients were recorded （0 - 4）. The results showed that the patients （ the distance of foci less than 5 mm from liver capsule or larger focus diameter） felt much pain than others. Focus size and the distance of focus from liver capsule had significant relation- ship with VAS （ P 〈 0.01 ）. However, age and source had no relationship with VAS （ P 〉 0.05）. Conclusion Focus adjacent to liver capsule or with lager diameter would cause much pain after ultrasound-guided percutaneous RFA under general anesthesia.