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目的探讨超声介导腹腔神经节毁损对胰腺癌痛患者的治疗作用。方法97例胰腺癌痛患者采用B超引导经皮穿刺,于腹腔动脉干根部旁侧注入无水乙醇15mL,实施腹腔神经节化学性毁损。对比观察治疗前后疼痛的视觉模拟评分(VAS)、血清SP和β-EP以及T细胞亚群水平变化。结果97例中仅1例穿刺失败,成功率98.7%,无严重并发症;VAS、血清SP和β-EP与术前差异有显著性(P<0.01,P<0.05,P<0.01);疼痛完全缓解率54.2%,部分缓解率21.9%,轻度缓解11.4%,无效12.5%,疼痛复发率仅10.7%,生存质量明显提高;与疼痛治疗前相比,胰腺癌痛患者的淋巴细胞T亚群水平显著上升(P<0.01)。结论该微创技术具有很高的安全性,能显著减轻胰腺癌性疼痛并提高细胞免疫水平。
Objective To investigate the therapeutic effect of ultrasound-mediated celiac ganglion destruction on patients with pancreatic cancer. Methods Ninety-seven patients with pancreatic cancer were treated with B-guided percutaneous puncture. 15 mL of absolute ethanol was infused into the celiac trunk of the celiac artery to perform chemical damage of the celiac ganglion. Visual acuity scores (VAS), changes of serum SP and β-EP and T cell subsets were observed and compared before and after treatment. Results Only one of 97 patients failed to puncture, with a success rate of 98.7%. There was no serious complication. VAS, serum SP and β-EP were significantly different from those before operation (P <0.01, P <0.05, P <0.01) The complete remission rate was 54.2%, the partial remission rate was 21.9%, the mild remission rate was 11.4%, the remission rate was 12.5%, and the recurrence rate was 10.7%. The quality of life was significantly improved. Compared with that before pain treatment, T lymphocyte subsets Group level increased significantly (P <0.01). Conclusion The minimally invasive technique is highly safe and can significantly reduce pancreatic cancer pain and improve cellular immunity.