CT引导下阻滞腹腔神经丛治疗顽固性癌痛

A preliminary study of treating intractable abdominal pain caused by cancer through neurolytic celiac plexus block guided by CT

目的 评价CT引导下阻滞腹腔神经丛治疗顽固性腹部癌痛的临床效果 ,并探讨影响止痛效果的因素。方法 8例腹部癌肿患者 ,出现顽固性腹痛的时间 7～ 2 0d不等 ,均经临床三级止痛效果不佳而行腹腔神经丛阻滞术。行双侧穿刺者 ,每侧注入阻滞剂无水乙醇 10ml;单侧者注入无水乙醇15ml。止痛评分采用 1～ 4分制。通过CT扫描观察阻滞剂分布情况。结果 经术后 1周、1、2、3、4、5和 6个月的随访观察 ,8例中止痛评分≥ 2分者分别占 7、7、6、5、4、3和 3例。术后即刻CT扫描显示 ,8例患者中 ,7例阻滞剂分布良好 ,1例分布不理想 ;无一例出现并发症。结论 CT引导下阻滞腹腔神经丛治疗顽固性癌痛 ,是一种安全、有效的止痛方法。

Objective To evaluate the therapeutic effect of neurolytic cliac plexus block (NCPB), and to analyze the factors related to the degree of pain relief.Methods Eight cases of the abdominal cancer with intractable pain from 7 days to 20 days, were treated by NCPB. During NCPB,10 ml or 15 ml, dehydrated alcohol was injected bilaterally for the former and unilaleral for the latter. The results of pain relief were classified into four score-grade. The spread of alcohol was observed through CT scaning.Results During the follow-up of 1W,1M,2M,3M,5M,6M,the cases of pain relief (≥2cases) were 7、7、6、5、4、3 and 3 cases respectively. With CT scaning, 7 cases showed the satisfactory spread of alcohol except 1 case which was not properly distributed. No severe complication occurred.Conclusions NCPB guided by CT is an effective and safe method for treating intractable abdominal cancer pain.