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不同体积70%酒精用于上腹部恶性肿瘤腹腔神经丛阻滞的比较评估

Comparative evaluation of different volumes of 70% alcohol in celiac plexus block for upper abdominal malignsancies.

作者信息

Dolly Archana, Singh Sarita, Prakash Ravi, Bogra Jaishri, Malik Anita, Singh Vinita

机构信息

Department of Anesthesiology, King George Medical University, Lucknow, Uttar Pradesh, India.

出版信息

South Asian J Cancer. 2016 Oct-Dec;5(4):204-209. doi: 10.4103/2278-330X.195346.

Abstract

CONTEXT

Celiac plexus block (CPB) (is an effective way to reduce cancer-associated pain in upper abdominal malignancies.

AIMS

To evaluate the efficacy and safety of different volumes of 70% alcohol in CPB.

SETTINGS AND DESIGN

Prospective, randomized, controlled clinical study.

SUBJECTS AND METHODS

Thirty patients of carcinoma gall bladder were randomly divided into three groups ( = 10) to receive 20, 30, and 40 ml of 70% alcohol in CPB.

STATISTICAL ANALYSIS USED

All the continuous data were assessed analysis of variance followed by tests (Tukey's Honestly Significant Difference test). Ordinal data were compared using Kruskal-Wallis H-test followed by Mann-Whitney U-test. Categorical comparisons were performed using Chi-square test.

RESULTS

A significant difference in visual analog scale (VAS) score of Group I, Group I and Group III was observed from week 6 onward until the end of the study. At all these time intervals, VAS scores in Group I was higher than both Groups II and III during this time interval. VAS scores in Group III were significantly lower as compared to Group II from week 10 onward until the end of the study. As compared to baseline, at all the follow-up intervals, mean morphine requirement was significantly lower in Group II and Group III. A quality of life (QOL) score of Group III were higher as compared to Group I. Between Group II and Group III, significant difference was observed at week 16 only when Group III had a higher score as compared to Group II.

CONCLUSIONS

VAS score, QOL, and reduction in morphine consumption were increased on increasing the volume of alcohol in CPB, 40 ml being most effective.

摘要

背景

腹腔神经丛阻滞(CPB)是减轻上腹部恶性肿瘤相关疼痛的一种有效方法。

目的

评估不同体积70%酒精用于腹腔神经丛阻滞的疗效和安全性。

设置与设计

前瞻性、随机、对照临床研究。

研究对象与方法

30例胆囊癌患者随机分为三组(每组n = 10),分别接受20、30和40毫升70%酒精进行腹腔神经丛阻滞。

统计分析方法

所有连续数据采用方差分析,随后进行检验(Tukey氏真实显著性差异检验)。有序数据采用Kruskal-Wallis H检验,随后进行Mann-Whitney U检验。分类比较采用卡方检验。

结果

从第6周直至研究结束,观察到I组、II组和III组的视觉模拟量表(VAS)评分存在显著差异。在所有这些时间间隔内,I组的VAS评分在此时间段高于II组和III组。从第10周直至研究结束,III组的VAS评分显著低于II组。与基线相比,在所有随访间隔中,II组和III组的平均吗啡需求量显著降低。III组的生活质量(QOL)评分高于I组。II组和III组之间,仅在第16周观察到显著差异,此时III组评分高于II组。

结论

在腹腔神经丛阻滞中增加酒精体积,VAS评分、生活质量和吗啡消耗量的降低均有所增加,40毫升最为有效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4b8c/5184761/2683052d1081/SAJC-5-204-g003.jpg

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