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目的提高腹腔神经丛穿刺的成功率,增强晚期癌痛的治疗效果,减少治疗中的并发症。方法选择上腹部脏器晚期癌痛患者139例,随机分为A、B两组,A组117例,采用主动脉旁腹腔神经丛毁损,B组22例,采用脚后间隙腹腔神经丛毁损。比较两组的治疗效果及并发症。结果两组治疗1周后,A组有效率97.4%,优良率88.9%,B组有效率95.4%,优良率77.3%。治疗后1月进行随访,A组有效率96.6%,优良率85.5%。B组有效率90.9%,优良率72.7%。两组优良率比较,差异均有统计学意义(P<0.05)。治疗中严重并发症发生率,A组0%,B组31.8%,差异有统计学意义(P<0.05)。治疗后一般并发症发生率,A组58.1%,B组59.1%,两组比较,差异无统计学意义(P>0.05)。结论主动脉旁毁损腹腔神经丛治疗上腹部晚期癌痛,较脚后间隙毁损,定位准确、穿刺容易、成功率高、疗效确切、并发症少。
Objective To improve the success rate of celiac plexus puncture, enhance the therapeutic effect of advanced cancer pain and reduce the complications during treatment. Methods One hundred and ninety-three patients with advanced cancer of the upper abdomen were selected and randomly divided into A and B groups. Group A (n = 117) underwent aortic para-celiac plexus injury. Group B (n = 22) received percutaneous lumbar plexus injury. The curative effect and complication of the two groups were compared. Results After two weeks of treatment, the effective rate in group A was 97.4%, the excellent and good rate was 88.9%, the effective rate in group B was 95.4% and the excellent and good rate was 77.3%. Follow-up was performed in January after treatment. The effective rate was 96.6% in group A, and the excellent and good rate was 85.5%. The effective rate in group B was 90.9%, the excellent and good rate was 72.7%. The two groups of excellent and good rates, the differences were statistically significant (P <0.05). The incidence of serious complications in treatment was 0% in group A and 31.8% in group B, the difference was statistically significant (P <0.05). The incidence of general complications after treatment was 58.1% in group A and 59.1% in group B, with no significant difference between the two groups (P> 0.05). Conclusion The peritoneal plexus adjacent to the aorta is superior to the late-stage cancer pain in the upper abdomen. It has the advantages of accurate positioning, easy puncture, high success rate, definite curative effect and less complications than the posterior gap.