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血管内去神经支配:缓解癌痛的新方法?

Endovascular Denervation: A New Approach for Cancer Pain Relief?

作者信息

Zhang Qi, Guo Jin-He, Zhu Hai-Dong, Zhong Ye-Ming, Pan Tao, Yin Hua-Qing, Dong Yong-Hua, Teng Gao-Jun

机构信息

Center of Interventional Radiology and Vascular Surgery, Department of Radiology, Zhongda Hospital, Southeast University, 87 Dingjiaqiao Road, Nanjing 210009, China.

Shanghai Golden Leaf Med Tec Co, Shanghai, China.

出版信息

J Vasc Interv Radiol. 2018 Dec;29(12):1639-1644. doi: 10.1016/j.jvir.2018.08.008. Epub 2018 Nov 7.

Abstract

PURPOSE

To evaluate the effects of endovascular denervation (EDN) on abdominal cancer pain relief.

MATERIALS AND METHODS

From April 2017 to February 2018, 7 cancer patients (2 males and 5 females) were enrolled in this study. The diagnoses of the patients included 3 pancreatic cancer, 2 cervical carcinoma, 1 cholangiocarcinoma, and 1 esophageal cancer with retroperitoneum lymph nodes invasion. Denervation was carried out at the abdominal aorta close to the origin of celiac artery and superior mesenteric artery with the use of a multielectrode radiofrequency ablation catheter with settings of time 120 seconds and temperature 60°C. The primary end point was improvement in pain scores. The secondary end points included change in quality of life, intake of narcotics, and the safety of EDN.

RESULTS

All of the patients experienced pain relief. The pain scores as measured by means of visual analog scores at 1, 2, 4, 8, and 12 weeks after the procedure were significantly lower than before the operation (P < .001). A > 4 score reduction was observed in all cases. A significant reduction in narcotics use within 3 months after the operation was also seen. The quality of life scores of the patients improved significantly (P < .005) with better sleep. No severe treatment-related adverse events or major complications were observed.

CONCLUSIONS

EDN is a safe and effective means to alleviate pain caused by cancer and may serve as a new approach for cancer pain relief and palliative care.

摘要

目的

评估血管内去神经支配术(EDN)对缓解腹部癌痛的效果。

材料与方法

2017年4月至2018年2月,7例癌症患者(2例男性,5例女性)纳入本研究。患者诊断包括3例胰腺癌、2例宫颈癌、1例胆管癌和1例伴有腹膜后淋巴结转移的食管癌。使用多电极射频消融导管在靠近腹腔干动脉和肠系膜上动脉起源处的腹主动脉进行去神经支配,设置时间为120秒,温度为60°C。主要终点是疼痛评分的改善。次要终点包括生活质量的变化、麻醉药品的摄入量以及EDN的安全性。

结果

所有患者均经历了疼痛缓解。术后1、2、4、8和12周通过视觉模拟评分法测得的疼痛评分显著低于手术前(P <.001)。所有病例均观察到疼痛评分降低>4分。术后3个月内麻醉药品使用量也显著减少。患者的生活质量评分显著提高(P <.005),睡眠改善。未观察到严重的治疗相关不良事件或主要并发症。

结论

EDN是缓解癌症所致疼痛的一种安全有效的方法,可作为癌症疼痛缓解和姑息治疗的新途径。

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