立体定向丘脑中央中核破坏术治疗癌性顽痛

Stereotaxic centro- median thalamotomy for treatment of intractable pain malignant tumor

本文报告自1982年10月到1989年1月,收治30例癌性顽痛病人,采用立体定向丘脑中央中核破坏术治疗,取得满意的止痛效果。本组所破坏目标结构点的座标取前、后连合联线中点后7～9mm,连线下1m～上2mm,中线旁7～9mm。我们认为采取以目标结构为中心,在其周边进行多点灶破坏术。可提高止痛效果及延长止痛时限,并对手术适应征选择和手术并发症的预防进行了讨论。

From Oct. 1982 to Jan. 1989 stereotaxic centro-median thalamotomy was performed in 30 cancerpatients with intractable pain. There were 15 malesand 15 females. The traumtic target was locatedat 7-9mm posterior to the mid point of intercommi-sural line, 1.0 mm below-2. 0mm above thatline 7-9mm deviated from the midline. The resultsof operation were satisfactory, and effective ratewas 90%. Three cases died of intracranialhematoma. due to post operative infection orcachexia. Our expenence is that traumatic pointsaround the target in thalamotomy are more reliable.and effect in control intractable pain. The indica-tion of operation therapeutic effect. and preventionof complication are discussed in detail.