本文選題：內(nèi)臟大小神經(jīng) + 阻滯　； 參考：《中國疼痛醫(yī)學(xué)雜志》2014年05期

【摘要】：目的:研究CT引導(dǎo)下經(jīng)皮穿刺胸腔入路內(nèi)臟大小神經(jīng)阻滯術(shù)治療胰腺癌疼痛的臨床療效。方法:選擇胰腺癌晚期上腹部或腰背部頑固性疼痛患者42例,在CT引導(dǎo)下經(jīng)胸腔入路雙針穿刺,行無水乙醇阻滯內(nèi)臟大小神經(jīng)。觀察有無各種并發(fā)癥;觀察并隨訪術(shù)前、術(shù)后1周、1個月、3個月患者的疼痛視覺模擬評分(visual analogue pain scale,VAS)隨訪并評定療效、生活質(zhì)量(quality of life,QOL)評分及口服嗎啡日用量。結(jié)果:無一例發(fā)生嚴(yán)重并發(fā)癥;術(shù)后1周臨床治愈36例,顯效6例;與術(shù)前比較,術(shù)后各時間點(diǎn)的VAS評分及嗎啡日用量均較術(shù)前顯著降低(P0.05),而術(shù)后各時間點(diǎn)QOL評分則顯著升高(P0.05)。結(jié)論:CT引導(dǎo)下經(jīng)皮穿刺胸腔入路內(nèi)臟大小神經(jīng)阻滯術(shù)治療胰腺癌頑固性疼痛療效好、安全性高、簡單易行,并顯著提高患者的生活質(zhì)量。
[Abstract]:Objective: to study the clinical effect of CT-guided percutaneous thoracotomy and visceral nerve block in the treatment of pancreatic cancer pain. Methods: Forty-two patients with intractable pain in the upper abdomen or lower back of advanced pancreatic cancer were selected. Under the guidance of CT, the visceral and small nerves were blocked by anhydrous alcohol. All kinds of complications were observed and followed up before operation, 1 week, 1 month and 3 months after operation. Visual analogue pain scale (VAS) was followed up to evaluate the efficacy, quality of life (QOL) score and daily dose of morphine. Results: no serious complications occurred, 36 cases were cured 1 week after operation, 6 cases were significantly improved. Compared with preoperative, the VAS score and daily dose of morphine at each time point after operation were significantly lower than those before operation (P 0.05), but the QOL score at each time point after operation was significantly higher than that before operation (P 0.05). Conclusion Percutaneous thoracotomy with small and small visceral nerve block under the guidance of CT is effective, safe, simple and effective in the treatment of intractable pain of pancreatic cancer. It also improves the quality of life of the patients.
【作者單位】： 寧波大學(xué)醫(yī)學(xué)院附屬李惠利醫(yī)院疼痛科;南昌大學(xué)第一附屬醫(yī)院疼痛科;
【分類號】：R739.5

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