不同入路CT导引下腹腔神经丛毁损术治疗上腹部癌性疼痛的疗效观察

Efficacy of CT-guided neurolytie celiac plexus block with difference routes for cancer pain in the upper abdomen

目的探讨不同入路CT导引下腹腔神经丛毁损术治疗上腹部癌性疼痛的临床疗效。方法选取2013年4月至2015年7月间宝鸡市中医医院收治的90例上腹部癌性疼痛患者,采用随机数表法分为前入路组和后入路组,每组45例。所有患者均行CT导引下腹腔神经丛毁损术,前入路组患者采用前入路法,后入路组患者采用后入路法,观察两组患者术后临床表现、手术成功率、治疗效果及并发症状况。结果前入路法与后入路法手术成功率均为100.0%,两组患者术后均有并发症表现,经适当治疗后痊愈,无严重并发症发生。前入路组患者临床短期(<1个月)显效率为70.1%,总有效率为96.3%,后入路组患者短期显效率为63.4%,总有效率为92.5%;前入路组长期(>3个月)显效率为50.3%,总有效率为90.1%,后入路组长期显效率为44.7%,总有效率为81.6%,前入路组患者临床短期与长期显效率和总有效率均较高,差异均有统计学意义(均P<0.05)。结论经前入路法CT导引下穿刺腹腔神经丛毁损术治疗癌性疼痛临床疗效较理想,值得推广。

Objective To evaluate the efficacy of CT-guided neurolytie celiac plexus block with difference routes for cancer pain in the upper abdomen.Methods Ninety patients with cancer pain in the upper abdomen were selected at Baoji Hospital of Traditional Chinese Medicine from April 2013 to July2015.Using the random number table method,patients were divided into the anterior approach group and the posterior approach group with 45 patients in each groupa.All patients underwent CT-guided celiac plexus,of whom 45 patients were treated with anterior approach,and the rest were treated with posterior approach.Clinical manifestations,success rate of surgery,treatment efficacy and complications were observed after the operation.Results The success rate was 100.0% for both the anterior and the posterior approach groups.Postoperative complications occurred in both groups but were not serious and relieved after proper treatment.The short-term（1 month） efficacy rate was 70.1% for the anterior approach group and63.4% for the posterior approach group;the overall efficacy rate was 96.3% for the anterior approach group and 92.5% for the posterior approach group.The long-term（3 months） efficacy rate was 50.3% for the anterior approach group and 44.7% for the posterior approach group;the overall efficacy rate was 90.1%for the anterior approach group and 81.6% for the posterior approach group（P0.05）.Conclusion CTguided celiac plexus block with anterior approach shows desired clinical efficacy,and is worthy of clinical application.