摘要
目的分析胰腺癌伴腹膜后淋巴结转移患者在CT引导下行腹腔神经丛毁损或腹腔神经丛毁损联合腹膜后肿大淋巴结无水乙醇注射治疗(简称联合治疗)胰腺癌相关疼痛的止痛效果。方法回顾性分析2014年1月至2018年12月郑州大学附属肿瘤医院187例因上腹痛控制不佳入院的胰腺癌伴腹膜后淋巴结转移患者临床资料。根据治疗方式分为两组:A组(n=48),在CT引导下行腹腔神经丛毁损治疗;B组(n=139),在CT引导下行联合治疗。分别比较手术前、手术后1周、1个月及3个月时的止痛效果、吗啡应用剂量以及不良反应发生情况。结果A组患者术前以及术后1 d、1周、1个月、3个月口服吗啡剂量分别为(107±34)、(65±23)、(35±12)、(48±18)、(81±25)mg,B组患者分别为(112±37)、(53±17)、(27±14)、(42±16)、(63±20)mg;与术前相比,两组患者术后1 d、1周、1个月以及3个月口服吗啡剂量均明显减少,差异均有统计学意义(P<0.05或P<0.01)。术后1周A组疼痛治疗有效率和优良率分别为83.3%和60.4%,B组分别为95.7%和75.5%;术后1个月A组分别为71.7%和45.6%,B组分别为89.0%和67.6%;术后3个月A组分别为48.6%和25.7%,B组分别为72.6%和47.0%;与A组相比,B组疼痛治疗有效率和优良率均增高,差异均有统计学意义(P<0.05或P<0.01)。两组患者术前及术后1 d恶心呕吐发生率差异均无统计学意义,但B组术后1周、1个月和3个月的恶心呕吐发生率明显降低,差异均有统计学意义(P<0.05或P<0.01)。与术前相比,A组术后1周和术后1个月的恶心呕吐发生率明显降低,差异均有统计学意义(P<0.01);B组术后1 d、1周、1个月以及3个月的恶心呕吐发生率均明显降低,差异均有统计学意义(P<0.01)。与术后1 d相比,A组术后1周和术后1个月的恶心呕吐发生率明显降低(P<0.05或P<0.01),B组术后1周、1个月以及3个月的恶心呕吐发生率均明显降低,差异均有统计学意义(P<0.01)。与术后1周相比
Objective To analyze the analgesic effect of CT-guided celiac nerve plexus destruction or celiac plexus destruction combined with absolute ethanol injection on retroperitoneal enlarged lymph nodes in patients with pancreatic cancer with retroperitoneal lymph node metastasis(combined therapy).Methods Retrospective analysis of clinical data of 187 patients with pancreatic cancer and retroperitoneal lymph node metastasis admitted to Zhengzhou University Cancer Hospital from January 2014 to December 2018 due to poor abdominal pain control.According to the treatment method,they were divided into 2 groups:Group A(n=48),treated with CT-guided celiac plexus destruction;Group B(n=139),treated with CT-guided combined therapy.The analgesic effect,morphine application dose,and adverse reactions were compared before surgery,1 week,1 month,and 3 months after surgery.Results The oral morphine doses of patients in Group A before surgery and 1 day,1 week,1 month,and 3 months after surgery were(107±34),(65±23),(35±12),(48±18),(81±25)mg.The oral morphine doses of patients in Group B before surgery and 1 day,1 week,1 month,and 3 months after surgery were(112±37),(53±17),(27±14),(42±16),(63±20)mg.Compared with that before surgery,the oral morphine doses were significantly reduced at 1 day,1 week,1 month,and 3 months after surgery in both groups(P<0.05 or P<0.01).The effective rate and excellent rate of pain treatment in Group A at 1 week after operation were 83.3%and 60.4%,in Group B were 95.7%and 75.5%,respectively.The effective rate and excellent rate of pain treatment in Group A at one month after operation were 71.7%and 45.6%,in Group B were 89.0%and 67.6%,respectively;The effective rate and excellent rate of pain treatment in Group A at three months after operation were 48.6%and 25.7%,respectively,in Group B were 72.6%and 47.0%;Compared with Group A,the effective rate and excellent rate of pain treatment in Group B were increased,and the differences were statistically significant(P<0.05 or P<0.01).There was no signific
作者
谢广伦
郭大鹏
刘畅
吴官鸿
陈昊
李志刚
Xie Guanglun;Guo Dapeng;Liu Chang;Wu Guanhong;Chen Hao;Li Zhigang(Department of Pain,Affiliated Cancer Hospital of Zhengzhou University,Zhengzhou 450000,China)
出处
《中华医学杂志》
CAS
CSCD
北大核心
2020年第5期357-362,共6页
National Medical Journal of China
基金
2016年河南省科技攻关项目(162102310320)
2017年河南省科技攻关项目(172102310688)
2020年河南省高等学校重点科研项目(20A320023)。
关键词
胰腺肿瘤
淋巴结
腹腔丛
疼痛
Pancreatic neoplasms
Lymph nodes
Celiac plexus
Pain
