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目的 :评价CT引导下经皮穿入淋巴结内腹腔神经丛阻滞术对伴有后腹膜淋巴结广泛肿大、融合 ,并侵犯、包裹腹腔神经丛的顽固性癌性腹痛的止痛效果。方法 :93例晚期癌症患者 ,均伴有后腹膜淋巴结广泛肿大 ,并融合成团块状。全部病例均有严重的上腹部疼痛 ,采用过麻醉类止痛药治疗 ,34例还接受过放射治疗 ,止痛效果均不佳。应用CT引导下穿入淋巴结内酒精阻滞方法进行治疗。结果 :治疗后即刻、2周、1个月、2个月、3个月、4个月的止痛有效率分别为 10 0 %、10 0 %、10 0 %、97.9%、96.6%、92 .5 %。肿大淋巴结均有明显坏死。结论 :对伴有后腹膜淋巴结广泛肿大 ,融合成块 ,并侵犯、包裹腹腔神经丛的顽固性癌性腹痛患者 ,用传统的膈脚前阻滞疗法止痛效果有限 ,应采用穿入淋巴结内阻滞疗法 ,可取得较好的止痛及使肿大淋巴结缩小的双重治疗效果 ,值得推广应用。
Objective: To evaluate the analgesic effects of CT-guided percutaneous celiac plexus blockade in perfused lymph nodes on intractable abdominal pain accompanied by extensive enlargement and fusion of retroperitoneal lymph nodes and invasion and entrapment of the celiac plexus. Methods: Ninety-three patients with advanced cancer were associated with extensive peritoneal lymph nodes enlargement and fused into clumps. All cases had severe epigastric pain, which was treated with anesthesia analgesics, and 34 patients had received radiation therapy. The analgesic effects were poor. CT-guided percutaneous alcohol blockade into lymph nodes was used for treatment. Results: The effective rates of pain relief immediately after treatment, 2 weeks, 1 month, 2 months, 3 months, and 4 months were 100%, 100%, 100%, 97.9%, 96.6%, and 92%, respectively. 5 %. The enlarged lymph nodes all had obvious necrosis. Conclusion: For patients with intractable abdominal pain associated with extensive enlargement of the retroperitoneal lymph nodes, fusion of masses, and encroachment of the celiac plexus, the use of traditional ankle blockers has limited analgesic effect and should be used within the lymph nodes Blocking therapy can achieve better analgesia and double effect of shrinking enlarged lymph nodes, which is worthy of popularization and application.