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目的探讨腰2交感神经节毁损术治疗癌性腰腿痛的临床疗效。方法癌性腰腿痛患者50例,在数字减影机数字减影血管造影(DSA)下用无水酒精行腰2交感神经节毁损术,对治疗前、治疗后7d、30d、90d分别行视觉模拟(VAS)及生活质量评分,并观察术中及术后并发症的发生率。结果与治疗前比较,治疗后7d、30d及90d的VAS评分明显降低,差异有统计学意义(P<0.05),VAS评分相互比较,无统计学差异(P>0.05)。与治疗前比较,治疗后7d、30d及90d的生活质量评分明显降低,差异有统计学意义(P<0.05),生活质量评分相互比较,无统计学差异(P>0.05)。50例癌性腰腿痛患者中,术后出现腰痛7例,发生率14%,神经损伤2例,发生率4%。未发生腰动脉、生殖股神经痛、肾脏损伤及蛛网膜下腔阻滞等并发症。结论腰2交感神经节毁损术治疗癌性腰腿痛有较好的临床疗效。
Objective To investigate the clinical efficacy of lumbar 2 sympathetic ganglia lesion in the treatment of cancer of lower back and leg pain. Methods Fifty patients with cancerous lumbar and lower back pain underwent digital subtraction angiography (DSA) with desiccation of lumbar 2 sympathetic ganglion with anhydrous alcohol. Before and after treatment, 7d, 30d and 90d after treatment, Visual analogue (VAS) and quality of life scores, and observed the incidence of intraoperative and postoperative complications. Results Compared with those before treatment, the VAS scores at 7d, 30d and 90d after treatment were significantly decreased (P <0.05). There was no significant difference in VAS scores between the two groups (P> 0.05). Compared with those before treatment, the scores of quality of life at 7d, 30d and 90d after treatment were significantly lower (P <0.05), and the quality of life scores were not significantly different from each other (P> 0.05). In 50 cases of patients with low back and leg pain, postoperative low back pain occurred in 7 cases, the incidence of 14%, nerve injury in 2 cases, the incidence of 4%. No lumbar artery, genital neuralgia, renal damage and subarachnoid block and other complications. Conclusion lumbar 2 sympathetic ganglia lesion for the treatment of cancer of low back pain have better clinical efficacy.