未能切除胰腺癌患者术中NCPB的临床意义

Clinical effect of infra-abdominal neurolytic celiac plexus block during operation in patients suffering from inoperable pancreatic cancer

目的研究术中腹腔神经丛阻滞对无法切除胰腺癌患者的镇痛疗效及并发症。方法41例患者经腹行直视下的腹腔神经丛阻滞,每人次注射无水酒精20—50ml,同时行胆肠转流或/和胃肠转流,部分患者行区域动脉化疗。结果腹腔神经丛阻滞后6个月内或已死亡者中有32例患者疼痛完全缓解,4例明显减轻,5例无明显效果。38例术中出现血压下降,15例术后腹泻,结论 术中直视下经腹行无水酒精腹腔神经丛阻滞对缓解未能切除胰腺癌患者的疼痛具有明显的镇痛效果。

Objective To investigate the analgesic effect of Intra-abdominal neurolytic celiac plexus block (NCPB) with anhydrous alcohol during operation in patients suffering from inoperable pancreatic cancer. Methods 41 cancer patients received neurolytic celiac plexus block during operation 20~50ml of anhydrous alcohol is injected into the celiac plexus, and biliary- jejunum drainage and/or stomach-jejunum drainage was done. Some patients received regional arterial chemotherapy. Results After NCPB,32cases (78.8%)of the group had complete pain relief, 4 cases (9.8%)get significant pain relief and 5 cases (11.4%)had no analgesic effects during the first 6 months or until death. Hypotension occurred in 38 cases (92.7%), and diarrhea in 15 cases (36.6%) of diving postoperdfire perid. Conclusion Intra-abdominal neurolytic celiac plexus block with anhydrous during operation is a safe and satisfactory analgesic effect in the management inoperable pancreatic cancer.