【摘要】 目的探讨内镜超声引导下腹腔神经丛毁损术(EUS-CPN)缓解胰腺癌所致癌性腹痛的临床效果。方法选取2013年1月至2014年1月安岳县人民医院收治的100例胰腺癌伴明显癌痛患者为研究对象,按随机数字表法分为对照组和观察组,各50例。对照组患者采用CT-CPN治疗,观察组患者采用EUS-CPN治疗。评价两组患者胰腺癌痛控制的临床效果,记录两组患者手术前后不同时间点的疼痛视觉模拟评分(VAS)及疼痛缓解度,并对围术期间患者的不良反应发生情况进行统计。结果术后1 d、1周、1个月、2个月,两组患者的VAS评分均呈下降趋势(P<0.05),且观察组患者术后各时间点的VAS评分均低于对照组,两组间、时点间、组间·时点间交互作用比较差异有统计学意义(P<0.05)。观察组术后1 d、1周、1个月、2个月的疼痛缓解率分别为54.0%(27/50)、76.0%(38/50)、100.0%(50/50)、100.0%(50/50),均高于对照组[34.0%(17/50)、52.0%(26/50)、68.0%(34/50)、76.0%(38/50)],差异有统计学意义(P<0.05)。随访2个月后,观察组患者停用镇痛药物的比例高于对照组[72.0%(36/50)比24.0(12/50)],而总并发症发生率低于对照组[18.0%(9/50)比38.0%(19/50)],差异有统计学意义(P<0.05)。结论 EUS-CPN对晚期胰腺癌所致癌性腹痛的疗效确切,可显著缓解癌痛,提高患者的生活质量,虽然术后易出现血压下降、腹泻等并发症,但经积极处理后均可很快恢复,可作为缓解胰腺癌痛较为安全、有效的方法。更多还原

【Abstract】 Objective To investigate effect of the endoscopic ultrasound-guided celiac plexus neurolysis( EUS-CPN) for clinical remission of the pancreatic cancerous abdominal pain. Methods Total of 100 cases of pancreatic cancer with significant pain in Anyue People’ s Hospital from Jan. 2013 to Jan. 2014 were included in the study,according to the random number table method they were divided into a control group and an observation group,50 cases in each group. The control group received CT-CPN,while the observation group received EUS-CPN. The clinical effect of pancreatic carcinogenic pain control of the two groups was evaluated,and the pain visual analogue scores( VAS) before and after surgery and the degree of pain relief at different time points of the two groups were recorded,and the perioperative adverse reactions statistics was carried out. Results After 1 d,1 week,1 month,2 months,VAS scores of both groups were decreased( P <0. 05),and the VAS scores of the observation group at each time point were lower than the control group,the differences between the two groups,between time points,and the interaction of groups· time points were statistically significant( P < 0. 05); postoperative pain relief progressed over time in both groups,and pain relief rates of the observation group after 1 d,1 week,1 month,2 months were 54. 0%( 27 /50),76. 0%( 38 /50),100. 0%( 50 /50),100. 0%( 50 /50),were higher than the control group[34. 0%( 17 /50),52. 0%( 26 /50),68. 0%( 34 /50),76. 0%( 38 /50) ]( P < 0. 05). After 2 months of follow-up two,disabled analgesic proportion of the observation group was higher than the control group[72. 0%( 36 /50) vs 24. 0%( 12 /50) ],but overall complication rate was lower than the control group[18. 0%( 9 /50) vs 38. 0%( 19 /50) ]( P < 0. 05). Conclusion EUS-CPN for the treatment of advanced pancreatic cancer-causing abdominal pain has exact effect,which can significantly relieve pain and improve the quality of life of the patients,although there can be postoperative drop in blood pressure,diarrhea and other complications,active treatment can realize fast recovery,therefore it can be used as a safe and effective method to alleviate the pain of pancreatic cancer.更多还原