CT 引导下经皮脊髓束切断术治疗难治性癌痛的疗效：14 例患者的经验。
Effectiveness of CT-guided percutaneous cordotomy in intractable cancer pain: Experience in 14 patients.
机构信息
Division of Algology, Anesthesiology and Reanimation Department, Faculty of Medicine, Akdeniz University, Antalya, Turkey.
出版信息
Pain Pract. 2024 Feb;24(2):296-302. doi: 10.1111/papr.13307. Epub 2023 Oct 17.
BACKGROUND
Severe and treatment-resistant pain is a major issue for patients with cancer. Cordotomy is an effective approach for addressing severe cancer-related pain. It is based on blocking the transmission of pain by damaging the lateral spinothalamic tract.
METHODS
Computed tomography guided cordotomy was performed on 14 patients who did not respond to medical and interventional pain management methods.
RESULTS
Fourteen patients with cancer pain underwent CT-guided percutaneous cordotomy. Pain relief was reported in 86% of the patients. The visual analog scale values before and after cordotomy were compared and a significant difference was found (p = 0.0001). The improvement in the Karnofsky Performance Scale score of the patients was found to be statistically significant (p = 0.0001).
CONCLUSION
We believe that CT-guided cordotomy, performed by experienced hands in a team of experienced individuals and applied to the right patients, is an effective treatment. However, it is crucial to exercise extreme caution regarding potential side effects and serious complications during the cordotomy procedure.
背景
严重且治疗抵抗性疼痛是癌症患者的主要问题。脊髓切开术是一种有效解决严重癌症相关疼痛的方法。它基于通过破坏外侧脊髓丘脑束来阻断疼痛的传递。
方法
对 14 名对药物和介入性疼痛管理方法无反应的患者进行了计算机断层扫描引导下脊髓切开术。
结果
14 例癌症疼痛患者接受 CT 引导下经皮脊髓切开术。86%的患者报告疼痛缓解。比较脊髓切开术前和术后的视觉模拟量表值，发现有显著差异（p=0.0001）。患者卡诺夫斯基绩效量表评分的改善具有统计学意义（p=0.0001）。
结论
我们认为，在经验丰富的团队中由经验丰富的医生进行 CT 引导脊髓切开术，并应用于合适的患者，是一种有效的治疗方法。然而，在脊髓切开术中必须极其小心潜在的副作用和严重的并发症。
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