CAJ | 학술논문

目的：评价四维CT引导经皮穿刺行腹腔神经丛阻滞术，对腹腔恶性肿瘤伴有腹膜后淋巴结转移，并侵犯、包裹腹腔神经丛的顽固性癌痛的止痛效果以及安全性。方法48例晚期癌症患者，均有严重的上腹部束带样疼痛、经影像学证实腹膜后淋巴结肿大。应用四维CT引导经皮穿刺对其腹腔神经丛阻滞治疗。结果治疗后24 h，2周，1、2、3个月的有效率分别为100%、96%、94%、90%和83%，治愈率分别为67%、64%、58%、52%和50%。围手术期无严重并发症。结论对恶性肿瘤伴有后腹膜淋巴结转移并侵犯、包裹腹腔神经丛的顽固性癌痛患者，采用四维CT引导腹腔神经丛阻滞术，可取得较好的止痛治疗效果，穿刺过程中实时监控，安全性高，具有较高的临床推广价值。
목적：평개사유CT인도경피천자행복강신경총조체술，대복강악성종류반유복막후림파결전이，병침범、포과복강신경총적완고성암통적지통효과이급안전성。방법48례만기암증환자，균유엄중적상복부속대양동통、경영상학증실복막후림파결종대。응용사유CT인도경피천자대기복강신경총조체치료。결과치료후24 h，2주，1、2、3개월적유효솔분별위100%、96%、94%、90%화83%，치유솔분별위67%、64%、58%、52%화50%。위수술기무엄중병발증。결론대악성종류반유후복막림파결전이병침범、포과복강신경총적완고성암통환자，채용사유CT인도복강신경총조체술，가취득교호적지통치료효과，천자과정중실시감공，안전성고，구유교고적림상추엄개치。
Objective To evaluate four-dimensional CT navigation percutaneous absolute ethanol nerve block therapy of celiac plexus embedded in metastatic lymph nodes in treating intractable carcinomatous abdominal pain. Methods A total of 48 patients with late stage cancers were enrolled in this study. All patients suffered from serious carcinomatous pain at upper abdomen and their retroperitoneal lymph nodes were extensively enlarged , together with the involved celiac plexus. As the patients failed to respond to opioid analgesics, four-dimensional CT navigation ethanol nerve block therapy of celiac plexus was carried out by pushing the puncture needle through the fused lym-phatic mass to celiac plexus site. The analgesic effects and complications were observed and the therapeutic results were evaluated. Results The analgesic effective rate at 24 h past procedure was 100%, and cure rate at 24 h, 2 weeks, 1, 2, 3 months after treatment was 67%、64%、58%、52%、50% respectively. No serious complications oc-curred during perioperative period. The quality of life was significantly improved in all patients. Conclusion For the treatment of intractable carcinomatous abdominal pain of invaded celiac plexus and retroperitoneal lymph node metas-tases from malignant tumor, CT-guided percutaneous ethanol nerve block therapy is a promising effective treatment. As it′s timely monitored during the whole procedure, it′s with insurable safety, and worth for an extensive clinical pro-motion.