腹腔神经丛毁损术联合电针治疗顽固胰腺癌疼痛的疗效观察

Observation on the efficacy of celiac plexus ablation combined with electroacupuncture in the treatment of pain induced by refractory pancreatic cancer

目的评估腹腔丛毁损术联合电针用于顽固性胰腺癌疼痛患者的镇痛效果。方法2015年6月~2018年12月纳入本院37例胰腺癌患者,采用随机数字法分为两组:腹腔神经丛毁损联合电针组(Ⅰ组,n=19)和腹腔神经丛毁损组(Ⅱ组,n=18),Ⅰ组:取穴、配穴,应用2 Hz和100 Hz交替进行疏密(DD)波,隔日1次,治疗3周,Ⅱ组:单纯腹腔神经丛毁损治疗。两组患者术后均口服吗啡控释片。观察术后1、2、3周VAS评分及QOL、吗啡控释片用量及电针相关并发症等情况。结果在电针治疗后1、2、3周时VAS评分明显低于Ⅱ组,Ⅰ组生活质量QOL评分较Ⅱ组明显升高(P<0.05)。此外,Ⅰ组吗啡用量较Ⅱ组明显降低(P<0.05)。结论腹腔神经毁损联合电针射频治疗,可以辅助减轻胰腺癌疼痛,同时又能提高患者的生活质量。

Objective To evaluate the analgesic effect of celiac plexus ablation combined with electroacupuncture in the treatment for the patients with pain induced by refractory pancreatic cancer.Methods From June 2015 to December 2018,37 patients with pancreatic cancer were included in our hospital.The patients were divided into two groups by random number method:celiac plexus ablation combined with electroacupuncture(groupⅠ,n=19)and celiac plexus ablation group(groupⅡ,n=18).Group I:acupoints were collected and matched,and 2 Hz and 100 Hz were used for alternating dilatational waves(DD)once every other day for three weeks of treatment;GroupⅡ:celiac plexus ablation was used alone.Both groups of patients were orally given morphine controlled release tablets after surgery.The VAS scores,QOL,dosage of morphine controlled-release tablets,and electroacupuncture-related complications at 1,2,and 3 weeks after surgery were observed.Results VAS scores at 1,2,and 3 weeks after electroacupuncture treatment were significantly lower than those in groupⅡ.The QOL score of quality of life in groupⅠwas significantly higher than that in groupⅡ(P<0.05).In addition,the dosage of morphine in groupⅠwas significantly lower than that in groupⅡ(P<0.05).Conclusion Electroacupuncture and radiofrequency therapy combined with celiac plexus ablation can help reduce the pain of pancreatic cancer,while improve the quality of life of patients.