射频热凝术治疗癌性疼痛的疗效分析

Effect of radiofrequency coagulation in patients with cancerous pain

目的评价控温射频热凝术治疗癌性疼痛对患者生活质量的影响。方法对77例符合四肢癌性疼痛的患者根据患者及家属意愿分为射频热凝组(45例)和神经阻滞组(32例)。两组患者均在数字减影X射线机引导下经皮穿刺到目标神经所在椎间孔外口,通过射频和神经刺激仪刺激,找到背根神经节进行控温射频热凝术或注射消炎镇痛液。静息状态下测定两组患者治疗前、治疗后第1及7天的疼痛评分采用视觉模拟评分法(VAS)、肌力评分及生活质量测定。结果射频热凝组在治疗后第7天的VAS评分及治疗后各时间点的肌力评分均优于神经阻滞组(P<0.05);射频热凝组治疗后第7天QLQ-C30量表各项指标评分均优于神经阻滞组(P<0.05)。结论射频热凝术治疗脊椎肿瘤转移引起的肢体癌性疼痛具有较好的疗效,对患者四肢运动功能影响甚微,尤其能提高患者的生活质量。

【Objective】 To evaluate the therapeutic effect of radiofrequency thermocoagulation on the quality of life in patients with cancer pain. Methods A total of 77 patients with quadripleal cancer pain were involved and divided into two groups according to will of patients and their families: radiofrequency thermocoagulation group and nerve block group. Both groups underwent DSA-guided percutaneous puncture to the external orifice of the intervertebral foramen of the target nerve. The radiofrequency and neurostimulators were used to stimulate the dorsal root ganglion for temperature-controlled radiofrequency thermocoagulation or injection of anti-inflammatory analgesic solution. The pain score, muscle strength score and quality of life were recorded at time before treatment, 1 day and 7 days after treatment. Results The VAS score and muscle strength score were improved in the observation group than those in the control group(P < 0.01). QLQ-C30 scale scores were obviously improved in observation group on the 7 th day after treatment when compared with that in the control group((P < 0.01). Conclusions Radiofrequency thermocoagulation exerts good curative effect on limb cancer pain without obvious compromising motor function of limbs.