Akinci Devrim, Akhan Okan
Department of Radiology, Hacettepe University School of Medicine, Sihhiye, 06100 Ankara, Turkey.
Eur J Radiol. 2005 Sep;55(3):355-61. doi: 10.1016/j.ejrad.2005.03.008.
Pain occurs frequently in patients with advanced cancers. Tumors originating from upper abdominal viscera such as pancreas, stomach, duodenum, proximal small bowel, liver and biliary tract and from compressing enlarged lymph nodes can cause severe abdominal pain, which do not respond satisfactorily to medical treatment or radiotherapy. Percutaneous celiac ganglia block (CGB) can be performed with high success and low complication rates under imaging guidance to obtain pain relief in patients with upper abdominal malignancies. A significant relationship between pain relief and degree of tumoral celiac ganglia invasion according to CT features was described in the literature. Performing the procedure in the early grades of celiac ganglia invasion on CT can increase the effectiveness of the CGB, which is contrary to World Health Organization criteria stating that CGB must be performed in patients with advanced stage cancer. CGB may also be effectively performed in patients with chronic pancreatitis for pain palliation.
晚期癌症患者经常会出现疼痛。起源于上腹部脏器(如胰腺、胃、十二指肠、近端小肠、肝脏和胆道)以及压迫肿大淋巴结的肿瘤可导致严重腹痛,这些腹痛对药物治疗或放疗反应不佳。在影像引导下进行经皮腹腔神经节阻滞(CGB)成功率高且并发症发生率低,可缓解上腹部恶性肿瘤患者的疼痛。文献中描述了根据CT特征,疼痛缓解与肿瘤侵犯腹腔神经节程度之间存在显著关系。在CT显示腹腔神经节侵犯早期进行该操作可提高CGB的有效性,这与世界卫生组织规定CGB必须在晚期癌症患者中进行的标准相反。CGB也可有效用于慢性胰腺炎患者的疼痛缓解。