超声引导下腹腔神经丛毁损治疗上腹部癌痛的安全性和有效性

Safety and efficacy of ultrasound-guided celiac plexus neurolysis for treatment of upper abdominal cancer pain

目的评估超声引导下腹腔神经丛毁损(CPN)治疗上腹部癌痛的安全性和有效性。方法对15例进展性上腹部癌痛患者行超声引导下CPN,利用视觉模拟量表(VAS)评分进行评估,记录CPN治疗前和治疗后即刻、1天、1周、1个月、3个月患者疼痛程度,并进行统计学分析。结果2例因治疗前评估无安全穿刺路径而被剔除。成功实施超声引导下CPN治疗13例。治疗后13例患者VAS评分明显低于治疗前(P<0.05)。治疗过程中无严重并发症发生。3例发生穿刺部位疼痛,24h后缓解;2例肠蠕动增快而出现腹泻;1例出现恶心、呕吐;1例术后出现低血压。结论超声引导下CPN安全有效,可作为微创治疗上腹部癌痛的方法之一。

Objective To evaluate the safety and efficacy of ultrasound-guided celiac plexus neurolysis (US-guided CPN) in patients with upper abdominal cancer pain. Methods Fifteen patients with advanced upper abdominal cancer pain underwent US-guided CPN. Visual analogue scale (VAS) was used to assess the extent of pain relief in patients,and the score of pain was recorded before CPN and immediately post-procedure, 1 day, 1 week, 1 month and 3 months after CPN, respectively. The differences in VAS scores of pain before and after CPN were analyzed statistically. Results The rest 2 patients were excluded for lacking of safe puncture path. CPN was successfully performed in 13 patients. Significant reduction of VAS score was observed in 13 patients after CPN ( P <0.05). No serious complication occurred. Transient irritant pain at the puncture site was noticed in 3 patients, which disappeared after 24 h. Transient diarrhea was presented in 2 patients for the increased intestinal peristalsis. Only 1 patient had transient nausea and vomiting, while post-procedural hypotension occurred in 1 patient. Conclusion US-guided CPN is safe and effective, which can be used as a visualization and minimally invasive method for treatment of upper abdominal cancer pain.