CAJ | 학술논문

目的：探讨双次腹腔神经丛毁损性阻滞治疗中上腹顽固性癌性内脏痛的疗效及安全性。方法对2005年1月-2011年12月在疼痛科住院保守治疗失败并接受CT引导下双次腹腔神经丛毁损性阻滞治疗的顽固性癌痛患者24例进行分析，评价患者疼痛缓解情况、不良反应以及并发症。结果双次腹腔神经丛毁损性阻滞能明显缓解患者的疼痛，VAS评分由术前的（8敂．3±1．3）分下降到术后的（1．4±1．1）分，吗啡用量由术前的（120±80）mg/d下降到术后的0，与术前比较差异均有统计学意义（ P ＜0．01， P ＜0．05）；疼痛缓解持续到术后6个月或直至患者死亡。其中发生轻微腹泻8例（33．3％），低血压9例（37．5％），一过性下肢无力1例（4．2％），但无手术相关死亡发生。结论 CT引导下双次腹腔神经丛毁损性阻滞可有效缓解中上腹顽固性癌性内脏痛患者的疼痛，显著减少阿片类药物用量，从而减少镇痛药的不良影响，且中远期疗效佳、安全性高。
목적：탐토쌍차복강신경총훼손성조체치료중상복완고성암성내장통적료효급안전성。방법대2005년1월-2011년12월재동통과주원보수치료실패병접수CT인도하쌍차복강신경총훼손성조체치료적완고성암통환자24례진행분석，평개환자동통완해정황、불량반응이급병발증。결과쌍차복강신경총훼손성조체능명현완해환자적동통，VAS평분유술전적（8구．3±1．3）분하강도술후적（1．4±1．1）분，마배용량유술전적（120±80）mg/d하강도술후적0，여술전비교차이균유통계학의의（ P ＜0．01， P ＜0．05）；동통완해지속도술후6개월혹직지환자사망。기중발생경미복사8례（33．3％），저혈압9례（37．5％），일과성하지무력1례（4．2％），단무수술상관사망발생。결론 CT인도하쌍차복강신경총훼손성조체가유효완해중상복완고성암성내장통환자적동통，현저감소아편류약물용량，종이감소진통약적불량영향，차중원기료효가、안전성고。
Objective To explore the efficacy and safety of two-time celiac plexus block for the treatment of abdomi-nal damage of intractable visceral pain caused by cancer .Methods For inpatients from January 2005 to December 2011 who were failed of conservative treatment of pain and underwent CT-guided celiac plexus blockade two-time block for the treatment of intractable cancer pain ,24 cases were analyzed to evaluate the pain relief ,adverse reactions and complications .Results Two-time celiac plexus blockade can relieve patients of pain , VAS score from preoperative (8.3 ±1.3) points down to postop-erative (1.4 ±1.1) points, morphine from preoperative (120 ±80 ) mg/d down to postoperative 0, compared with preopera-tive differences were statistically significant ( P <0.01 or P <0.05);pain relief last 6 months or until death.Mild diarrhea which occurred in 8 cases (33.3%), hypotension in 8 cases (37.5%), transient lower extremity weakness in 1 case (4.2%), but no procedure-related deaths occurred.Conclusion CT-guided celiac plexus blockade double times of arrest can effectively alleviate the intractable abdominal visceral pain in patients with cancer pain , significantly reduced opioid con-sumption, thus reducing the adverse effects of analgesics , and the long-term clinical outcome and safe .