超声辅助腹腔神经丛毁损术治疗晚期上腹部癌痛的临床研究

摘要:

目的 评估超声辅助后入路腹腔神经丛毁损术应用于晚期上腹部癌痛的可行性和安全性。方法 选择我院2019年1月2021年8月收治的30例确诊上腹部脏器晚期癌并伴难以忍受的癌痛并且强阿片类止痛药治疗效果欠佳的患者，采用超声辅助后入路行腹腔神经丛毁损术，治疗后即刻、1天、1周、1个月进行VAS疼痛评分，术中及术后观察有无严重并发症（腹腔出血、截瘫、肛门或膀胱括约肌功能障碍、动脉损伤、腹膜后血肿等）发生。结果 30例患者治疗后即刻、治疗后1天、1周、1个月的VAS评分较治疗前明显降低，p<0.01，随访1个月镇痛总有效率为100%；治疗过程中均无严重并发症发生。结论 超声辅助后入路腹腔神经丛毁损术应用于晚期上腹部癌痛安全有效，可作为治疗晚期上腹部癌痛的方法之一。

Abstract:

Objective to evaluate the feasibility and safety of ultrasound-assisted posterior approach celiac plexus destruction in the treatment of advanced upper abdominal cancer pain. Methods 30 patients with advanced cancer of upper abdominal organs diagnosed in our hospital from January 2019 to July 2021 and with unbearable cancer pain and poor therapeutic effect of strong opioid analgesics were selected. Abdominal plexus destruction was performed through ultrasonic assisted posterior approach. VAS pain score was performed immediately, 1 day, 1 week and 1 month after treatment. Whether there were serious complications (abdominal bleeding Paraplegia, anal or bladder sphincter dysfunction, arterial injury, retroperitoneal hematoma, etc.). Results the VAS scores of 30 patients immediately after treatment, 1 day, 1 week and 1 month after treatment were significantly lower than those before treatment (P < 0.01). The total effective rate of analgesia was 100%; There were no serious complications during the treatment. Conclusion ultrasound assisted posterior approach celiac plexus destruction is safe and effective in the treatment of advanced epigastric cancer pain.