CT引导下腹腔神经丛无水乙醇毁损术对癌因性上腹痛的镇痛效果

Analgesic effect of CT-guided ethanol celiac plexus neurolysis on cancer-related epigastric pain

目的探讨CT引导下腹腔神经丛无水乙醇毁损术对癌因性上腹痛的镇痛效果。方法根据止痛方法的不同将89例癌因性上腹痛患者分为观察组(n=45)和对照组(n=44),对照组患者采用蛛网膜下腔镇痛,观察组患者采用CT引导下腹腔神经丛无水乙醇毁损术镇痛。比较两组患者的疼痛程度[视觉模拟评分法(VAS)]、止痛有效率、生活质量[卡氏功能状态(KPS)评分]及并发症发生情况。结果治疗后1周、1个月及3个月,两组患者的VAS评分均低于本组治疗前,且观察组患者的VAS评分均低于对照组,差异均有统计学意义(P<0.05)。观察组患者的止痛总有效率为97.78%(44/45),高于对照组患者的79.55%(35/44),差异有统计学意义(P<0.05)。治疗后1周、1个月及3个月,两组患者的KPS评分均高于本组治疗前,且观察组患者KPS评分均高于对照组,差异均有统计学意义(P<0.05)。观察组患者的并发症总发生率为8.89%(4/45),与对照组患者的4.76%(2/44)比较,差异无统计学意义(P>0.05)。结论CT引导下腹腔神经丛无水乙醇毁损术对癌因性上腹痛具有良好镇痛效果,可提高患者的生活质量,安全可靠。

Objective To investigate the analgesic effect of CT-guided ethanol celiac plexus neurolysis on cancer-related epigastric pain.Method A total of 89 patients with cancer-related epigastric pain were divided into observation group(n=45)and control group(n=44)according to different pain relief methods.The patients in the control group were treated with subarachnoid analgesia,and the patients in the observation group were treated with CT-guided ethanol celiac plexus neurolysis for analgesia.The pain severity[visual analogue scale(VAS)],the effective rate of analgesia,the quality of life[Karnofsky performance status(KPS)score],and the occurrence of complications were compared between the two groups.Result After one week,one month,and three months of treatment,the VAS scores of patients in the two groups were lower than those before treatment,and the VAS scores of patients in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).The total effective rate of pain relief in the observation group was 97.78%(44/45),which was higher than 79.55%(35/44)in the control group,and the difference was statistically significant(P<0.05).After one week,one month,and three months of treatment,the KPS scores of the two groups were higher than those before treatment,the scores of the observation group were higher than those of the control group,and the differences were statistically significant(P<0.05).The total incidence of complications in the observation group was 8.89%(4/45),compared with 4.76%(2/44)in the control group,the difference was not statistically significant(P>0.05).Conclusion CT-guided ethanol celiac plexus neurolysis has a good analgesic effect on cancer-related epigastric pain,can improve the quality of life of patients,and is safe and reliable.