Giménez A, Martínez-Noguera A, Donoso L, Catalá E, Serra R
Department of Radiology, Hospital de Sant Pau, Facultad de Medicina, Universidad Autónoma, Barcelona, Spain.
AJR Am J Roentgenol. 1993 Nov;161(5):1061-3. doi: 10.2214/ajr.161.5.8273610.
The purpose of this study was to evaluate the usefulness of sonographically guided percutaneous neurolysis of the celiac plexus in patients with abdominal tumors or chronic pancreatitis in whom systemic analgesics were ineffective.
Neurolysis of the celiac plexus was performed in 38 patients, 34 with neoplastic disease and four with chronic pancreatitis. Under sonographic guidance, a 22-gauge needle was advanced by the anterior route to the area above the celiac plexus, and 30-40 ml of 50% alcohol was injected. Pain relief was assessed 1 week, 6 months, and 1 year after the procedure. Patients subjectively rated the pain after treatment as totally relieved, partially relieved, or unchanged.
At 1 week and at 6 months after treatment, pain was totally relieved in 61% of patients, partially relieved in 31%, and unchanged in 8%. After 1 year, pain was totally relieved in 39%, partially relieved in 52%, and unchanged in 9%. The complications observed were five cases of mild diarrhea and one case of retroperitoneal pain, which subsided with conservative treatment.
The anterior, sonographically guided approach appears to be as successful as other percutaneous techniques for neurolysis of the celiac plexus.
本研究旨在评估超声引导下经皮腹腔神经丛松解术对全身镇痛药治疗无效的腹部肿瘤或慢性胰腺炎患者的有效性。
对38例患者实施腹腔神经丛松解术，其中34例患有肿瘤性疾病，4例患有慢性胰腺炎。在超声引导下，通过前路将22号穿刺针推进至腹腔神经丛上方区域，并注入30 - 40毫升50%乙醇。在术后1周、6个月和1年评估疼痛缓解情况。患者主观评价治疗后的疼痛为完全缓解、部分缓解或无变化。
治疗后1周和6个月时，61%的患者疼痛完全缓解，31%的患者部分缓解，8%的患者无变化。1年后，39%的患者疼痛完全缓解，52%的患者部分缓解，9%的患者无变化。观察到的并发症为5例轻度腹泻和1例腹膜后疼痛，经保守治疗后缓解。
超声引导下前路腹腔神经丛松解术似乎与其他经皮腹腔神经丛松解技术一样成功。
