经腹腔神经丛阻滞治疗有反应的患者行正中弓状韧带松解术后的临床转归。

Clinical Outcomes after Median Arcuate Ligament Release in Patients Responsive to Celiac Plexus Block.

机构信息

Division of Vascular and Interventional Radiology, Department of Radiology, University of Michigan Health Systems, Ann Arbor, Michigan.

Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, Michigan.

出版信息

J Vasc Interv Radiol. 2024 Apr;35(4):558-562. doi: 10.1016/j.jvir.2023.12.569. Epub 2024 Jan 3.

DOI:10.1016/j.jvir.2023.12.569

PMID:38181971

Abstract

PURPOSE

To determine if symptom relief with celiac plexus block (CPB) is associated with favorable clinical outcomes after median arcuate ligament release (MALR) surgery.

MATERIALS AND METHODS

A retrospective review was performed from January 2000 to December 2021. Fifty-seven patients (42 women, 15 men; mean age, 43 years [range, 18-84 years]) with clinical and radiographic features suggestive of median arcuate ligament syndrome (MALS) underwent computed tomography (CT)-guided percutaneous CPB for suspected MALS. Clinical outcomes of CPB and MALR surgery were correlated. Adverse events were classified according to the Society of Interventional Radiology (SIR) guidelines.

RESULTS

CT-guided percutaneous CPB was successfully performed in all 57 (100%) patients with suspected MALS. A cohort of 38 (67%) patients showed clinical improvement with CPB. A subset of 28 (74%) patients in this group subsequently underwent open MALR surgery; 27 (96%) responders to CPB showed favorable clinical outcomes with surgery. There was 1 (4%) CPB-related mild adverse event. There were no moderate, severe, or life-threatening adverse events.

CONCLUSIONS

Patients who responded to CPB were selected to undergo surgery, and 96% of them improved after surgery.

摘要

目的

确定腹腔神经丛阻滞 (CPB) 缓解症状是否与正中弓状韧带松解术 (MALR) 后有利的临床结果相关。

材料和方法

回顾性研究于 2000 年 1 月至 2021 年 12 月进行。57 例（42 名女性，15 名男性；平均年龄 43 岁 [范围，18-84 岁]）具有临床和影像学特征提示正中弓状韧带综合征（MALS）的患者接受了计算机断层扫描 (CT) 引导的经皮 CPB 以治疗疑似 MALS。对 CPB 和 MALR 手术的临床结果进行了相关性分析。根据介入放射学会 (SIR) 指南对不良事件进行分类。

结果

所有 57 例（100%）疑似 MALS 的患者均成功完成 CT 引导下经皮 CPB。CPB 后有 38 例（67%）患者的临床症状得到改善。在这组患者中，有 28 例（74%）患者进一步接受了开放性 MALR 手术；CPB 应答者中有 27 例（96%）手术临床效果良好。有 1 例（4%）CPB 相关轻度不良事件。无中度、重度或危及生命的不良事件。