Department of Radiology, University of Missouri Columbia, One Hospital Drive, Columbia, United States;University of Missouri Columbia School of Medicine, One Hospital Drive, Columbia, United States.
Department of Radiology, University of Missouri Columbia, One Hospital Drive, Columbia, United States.
Diagn Interv Radiol. 2020 Jan;26(1):53-57. doi: 10.5152/dir.2019.19179.
PURPOSE Post-thoracotomy pain syndrome is a common condition affecting up to 50% of post-thoracotomy patients. However, percutaneous computed tomography (CT)-guided intercostal nerve cryoablation may provide symptomatic benefit in chronic and/or refractory cases. METHODS A retrospective review of our institution's comprehensive case log from October 2017 to September 2018 for patients who underwent cryoablation was analyzed. Thirteen patients with post-thoracotomy pain syndrome, refractory to medical management, were treated with CT-guided intercostal nerve cryoablation. Most patients had treatment of the intercostal nerve at the level of their thoracotomy scar, two levels above and below. The safety and technical success of this technique and the clinical outcomes of the study population were then retrospectively reviewed. RESULTS Of the patients, 69% experienced significant improvement in their pain symptoms with a median pain improvement score of 3 points (range, -1 to 8 points) over a median follow-up of 11 months (range, 2-18.6 months). Complications included pneumothorax in 8% and pseudohernia in 23% of patients. CONCLUSION CT-guided intercostal nerve cryoablation may be an effective technique in the treatment of post-thoracotomy pain syndrome and requires further study.
术后胸痛综合征是一种常见病症，影响多达 50%的剖胸术后患者。然而，经皮 CT 引导下肋间神经冷冻消融术可能对慢性和/或难治性病例提供症状缓解。
对我院 2017 年 10 月至 2018 年 9 月期间接受冷冻消融术的患者的综合病例记录进行回顾性分析。13 例术后胸痛综合征患者经医学治疗无效，接受 CT 引导下肋间神经冷冻消融术治疗。大多数患者在剖胸切口水平、上下两个肋间神经水平接受治疗。然后回顾性分析该技术的安全性和技术成功率以及研究人群的临床结果。
在患者中，69%的患者疼痛症状显著改善，中位数疼痛改善评分 3 分（范围-1 至 8 分），中位数随访时间为 11 个月（范围 2-18.6 个月）。并发症包括气胸 8%，假性疝 23%。
CT 引导下肋间神经冷冻消融术可能是治疗剖胸术后胸痛综合征的有效方法，需要进一步研究。
