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目的 评价CT导引下腹腔神经丛阻滞治疗上腹部癌性疼痛的应用价值 ,并对其技术方法等进行探讨。材料与方法 5 8例由胰腺癌、肝癌、胃癌、结肠癌、胆管癌引起的顽固性上腹痛或伴有牵涉性背痛的患者经CT导引后路双侧腹腔神经丛酒精阻滞 ,止痛效果被分为 0～Ⅲ级。将 5 8例分为胰腺癌组及非胰腺癌组 ,并将两组疗效进行对比。利用工作站三维重建观察对比剂扩散情况。结果 经 3个月随访 ,2周、1个月、2个月、3个月止痛总有效率分别为 93 .10 %、87.93 %、85 .45 %和 79.5 9%。胰腺癌组和非胰腺癌组对比 ,止痛总有效率无显著差异。止痛效果良好的患者可观察到对比剂扩散较好 ,能从两侧相互汇合包绕腹主动脉。 5 8例中无 1例出现严重并发症。结论 CT导引下双侧后路腹腔神经丛阻滞是治疗上腹顽固性癌性疼痛的有效、安全的方法
Objective To evaluate the value of CT-guided celiac plexus block in the treatment of cancer pain in the upper abdomen, and to discuss its technical methods. Materials and Methods 58 patients with intractable upper abdominal pain or associated back pain caused by pancreatic cancer, liver cancer, gastric cancer, colon cancer and cholangiocarcinoma were subjected to CT-guided bilateral abdominal cerebrospinal plexus alcohol block and analgesia. The effect is divided into 0 to III levels. 58 cases were divided into pancreatic cancer group and non-pancreatic cancer group, and the efficacy of the two groups was compared. Using workstation three-dimensional reconstruction to observe the spread of contrast agents. Results After 3 months of follow-up, the total effective rates of pain at 2 weeks, 1 month, 2 months, and 3 months were 93.10%, 87.93%, 85.45%, and 79.59%, respectively. There was no significant difference in the total effective rate of analgesia between the pancreatic cancer group and the non-pancreatic cancer group. Patients with good analgesic effects can observe better diffusion of contrast agents and can confluently surround the abdominal aorta from both sides. None of the 58 cases had serious complications. Conclusion CT-guided bilateral posterior celiac plexus block is an effective and safe method for the treatment of intractable cancer pain in the upper quadrant