摘要
【目的】运用伽玛刀和射频热凝技术毁损癌症顽痛患者的丘脑中央中核(CM核),初步探讨它们治疗顽固性癌痛患者的镇痛效果和并发症。【方法】伽玛刀组共15例,并与我们已报道的射频热凝(共90例)治疗相比较。采用世界卫生组织推荐的10分法评定手术前后的疼痛程度。【结果】两组患者术前疼痛计分均在7分以上,术后降至0～3分。伽玛刀组随访发现,4例(27%)患者有不同程度疼痛复发,术后仅并发轻度的头痛、头昏和呕吐。既往发表的射频热凝组随访,有24例(27%)患者有不同程度疼痛复发,两组计分均在5分以下;其余患者均持续止痛,有3例(3%)达2年多。术后并发症:嗜睡15例,尿失禁10例,语言错乱8例,一侧动眼神经麻痹3例。经对症处理后两组的并发症均消失。【结论】CM核毁损是治疗各类顽固性癌痛有效的方法,伽玛刀和热凝射频的效果大体相同,伽玛刀比射频热凝毁损的并发症相对较轻和少。
[Objective] There is no perfect method to control cancer pain. It is reported that nucleus centromedianus thalami plays a crucial role in analgesia of central nerve system. The authors conducted this study, based on the clinical treatment of two groups involving various cancer pains by gamma knife and radiofrequency coagulation lesions, to explore the pain-relieving effects and complications after damaging nucleus centromedianus thalami. [Methods] In the gamma knife group, 15 cases of intractable cancer pain were treated, including 5 cases （33%） of lung cancer, 3 cases （20%） of nasopharyngeal carcinoma, 3 cases （20%） of intestinal cancer, 2 cases （13%） of cervical carcinoma, 1 cases （7%） of osteocarcinoma, and 1 cases （7%） of cancer pancreas. And in the radiofrequency coagulation lesions group, 90 cases （which were reported by the authors formerly ） were treated [including 36 cases （40%） of lung cancer, 21 cases （23%） of nasopharyngeal carcinoma, 10 cases （11%） of intestinal cancer, 8 cases （9%） of cancer of pancreas and osteocarcinoma, 4 cases （4%） of carcinoma of kidney, and 3 cases （3%） of hepatocarcinoma）. The lO-grade method recommended by WHO was used to rank pain degree. [Results] The both groups average pain grade in this study went above 7 scores, but dropped to 0-3 scores after operation, according to the 10 grade method by WHO. In the gamma knife group, a life-long tracing observation indicted that cancer pain in 4 cases relapsed to varying degrees. The complications include light headache, dizzy, and vomiting. In the radiofrequency coagulation lesions group, 24 cases relapsed, but both groups were below 5 scores. The rest of the patients were analgesic persistently, 3 cases among whom lasted for as long as 2 year. The complications were 15 of somnolence, 10 of urinary incontinence,8 of divagation, and 3 of unilateral oculomotorparalysis. The complications in both groups released after symptomatie treatments. [Conclusion] Nucleus eentromedianus thal
出处
《中山大学学报（医学科学版）》
CAS
CSCD
北大核心
2007年第3期332-335,共4页
Journal of Sun Yat-Sen University:Medical Sciences
基金
广东省医药卫生科研基金(编号A2005356)
关键词
伽玛刀
射频
丘脑中央中核
毁损
癌痛
gamma knife
centromedianus nucleus
operation
cancer pain
