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目的回顾分析内镜超声引导下腹腔神经丛阻滞术(EUS-CPN)对初诊为晚期胰腺癌的止痛效果。方法对8例初诊为胰腺癌患者应用EUS-CPN,在腹腔干发出处上方临近的组织内用一针法无水乙醇注射或植入125I放射线粒子。于术前、术后1周、1月时VAS法作疼痛评分,评分减少≥3和<3分别定义为疼痛缓解和无缓解。记录并发症。结果 8例患者均经EU下穿刺活检确诊为晚期胰腺癌。7例接受一针法无水乙醇注射,1例在腹腔干旁和胰腺肿瘤内分别植入2粒和18粒放射线粒子。术前疼痛评分中有6例为重度疼痛,2例为中度疼痛;术后I周评估,6例(75%)疼痛明显缓解;1月后评价,7例(87 5%)患者轻度疼痛,仅1例患者为中度疼痛。患者术前VAS疼痛评分为8.0±1.51,术后1周VAS疼痛评分为5.1±1.64,与术前相比差异显著(P<0.01),术后1个为2.9~1.13,与术前相比差异非常显著(P<0.01)。结论 EUS-CPN对初诊为晚期胰腺癌的患者有较好的止痛作用。
Objective To retrospectively analyze the analgesic effect of endoscopic ultrasonography guided celiac plexus block (EUS-CPN) on newly diagnosed advanced pancreatic cancer. Methods Eight cases of newly diagnosed pancreatic cancer patients were treated with EUS-CPN. One needle injection of absolute ethanol or 125I radioactive particles was performed in the tissue above the celiac trunk. Pain was assessed by VAS at preoperative, 1 week, and 1 month postoperatively, with a reduction of ≥3 and <3 as pain relief and no relief, respectively. Record complications. Results All the 8 patients were diagnosed as advanced pancreatic cancer by needle biopsy. Seven patients received one-shot ethanol injection, and one patient had 2 and 18 radioactive particles implanted in the peritoneal cavity and pancreatic tumors, respectively. Six of the preoperative pain scores were severe pain and two were moderate pain; six weeks (75%) of postoperative pain were significantly relieved; one month later, seven patients (87.5%) were mild Pain, only 1 patient was moderate pain. The preoperative VAS pain score was 8.0 ± 1.51 and the VAS pain score at 1 week postoperatively was 5.1 ± 1.64, which was significantly different from that before operation (P <0.01). The postoperative one was 2.9 to 1.13, which was significantly lower than that before operation The difference was significant (P <0.01). Conclusion EUS-CPN has a good analgesic effect on newly diagnosed patients with advanced pancreatic cancer.