目的探讨不同入路CT导引下腹腔神经丛毁损术治疗上腹部癌性疼痛的临床疗效。方法选取2013年4月至2015年7月间宝鸡市中医医院收治的90例上腹部癌性疼痛患者,采用随机数表法分为前入路组和后入路组,每组45例。所有患者均行CT导引下腹腔神经丛毁损术,前入路组患者采用前入路法,后入路组患者采用后入路法,观察两组患者术后临床表现、手术成功率、治疗效果及并发症状况。结果前入路法与后入路法手术成功率均为100.0%,两组患者术后均有并发症表现,经适当治疗后痊愈,无严重并发症发生。前入路组患者临床短期(<1个月)显效率为70.1%,总有效率为96.3%,后入路组患者短期显效率为63.4%,总有效率为92.5%;前入路组长期(>3个月)显效率为50.3%,总有效率为90.1%,后入路组长期显效率为44.7%,总有效率为81.6%,前入路组患者临床短期与长期显效率和总有效率均较高,差异均有统计学意义(均P<0.05)。结论经前入路法CT导引下穿刺腹腔神经丛毁损术治疗癌性疼痛临床疗效较理想,值得推广。 Objective To investigate the clinical effects of CT-guided celiac plexus injury in the treatment of upper abdominal cancer pain. Methods 90 patients with upper abdominal cancer pain treated in Baoji Hospital of Traditional Chinese Medicine from April 2013 to July 2015 were randomly divided into anterior approach group and posterior approach group with 45 cases in each group. All patients underwent CT-guided celiac plexus injury, the anterior approach group patients with anterior approach, posterior approach group patients with posterior approach, the two groups were observed after the clinical manifestations, the success rate of surgery, treatment Effects and complications. Results The success rates of anterior approach and posterior approach were both 100.0%. Complications were found after operation in both groups. After appropriate treatment, no complications were found. The short-term clinical efficacy (<1 month) was 70.1% and the total effective rate was 96.3%. The short-term effective rate was 63.4% in the posterior approach group and the total effective rate was 92.5%. The long-term (> 3 months), the effective rate was 50.3% and the total effective rate was 90.1%. The long-term effective rate was 44.7% and the total effective rate was 81.6% in the posterior approach group. The clinical short-term and long-term effective rates and total Efficacy were higher, the differences were statistically significant (P <0.05). Conclusion Anterior approach CT guided percutaneous celiac plexus injury in the treatment of cancer pain clinical efficacy is ideal, it is worth promoting.