摘要
目的观察CT引导下腹腔神经丛阻滞术对胰腺癌合并重度腹痛的镇痛效果及不良反应。方法 40例伴重度腹痛的胰腺癌患者应用随机数字表分为2组:药物治疗组(药物组)20例,予硫酸吗啡缓释片10mg口服,每日2次,根据镇痛效果逐步调整剂量至30mg,每日2次;介入治疗组(介入组)20例,在CT引导下经背侧入路经皮穿刺腹腔神经丛,注射无水乙醇15～20ml行损毁治疗。治疗后评价疼痛缓解度和不良反应。结果疼痛缓解度:药物组完全缓解(CR)1例,明显缓解(PR)11例,轻度缓解(MR)5例;介入组CR 17例,PR 2例,MR 1例,明显缓解率介入组(95.0%)高于药物组(60.0%),差异有统计学意义(P<0.05)。介入组不良反应发生率(25.0%)明显低于药物组(90.0%),差异亦有统计学意义(P<0.01)。结论 CT引导下腹腔神经丛阻滞术治疗胰腺癌合并重度腹痛疗效确切、安全性高。
Objective To evaluate the therapeutic effect of neurolytic celiac plexus block（NCPB） guided by computerized tomography（CT） on pancreatic cancer with abdominal pain.Methods 40 patients with pancreatic cancer and severe abdominal pain were divided into two groups randomly with random number table.Group A（treatment group） with 20 cases, thy were treated with morphine sulfate sustained-release tablets,10mg,bid,and gradually adjust the dose according to analgesic efficacy to 30 mg,bid.Group B（intervention group） with 20 cases,there were treated with NCPB.During NCPB,dehydrated alcohol 15～20 ml was injected bilaterally.The pain relief degrees and adverse effects were observed after treatment. Results In group A,there were 1 complete remission（CR）,11 partial remissions（PR）,5 minor remissions（MR）,the relief rate（CR ＋ PR）was 60.0%.In group B,there were 17 CR,2 PR,1 MR,the relief rate was 95.0%,the efficacy of group B was better than the efficacy of group A,there was a significant difference between the two group（P0.05）.The incidence of adverse reactions in the intervention group（25.0%） was significantly lower than the drug group（90.0%）,there was a significant difference between the two groups（P0.01）.Conclusion NCPB guided by CT is an effective and safe method for treating intractable pancreatic cancer combined with severe abdominal pain.
出处
《疑难病杂志》
CAS
2011年第7期512-514,共3页
Chinese Journal of Difficult and Complicated Cases
关键词
介入治疗
胰腺癌
腹痛
癌性
腹腔神经丛阻滞
CT引导
Interventional treatment
Pancrentic cancer
Obdominal pain
cancer
Neurolytic celiac plexus
CT guiding
