Pinzani A, Micheletto G, Bortolami A, Ravasini R
Servizio di Radiologia, Ambulatorio di Terapia del Dolore, Venezia.
Radiol Med. 1993 May;85(5):648-52.
June 1991 to June 1992, twelve CT-guided percutaneous celiac plexus neurolyses were performed by a new simplified technique with the patient in left-hand side decubitus and a single right lumbar needle access. CT guidance allows the interventional radiologist to locate the best access point on the skin, to give the needle the appropriate depth and inclination to avoid passing through pleura, parenchyma and vessels, and finally to check the correct position of the needle tip and the spread of neurolytic solution. In left-hand side decubitus, fat and loose connective tissue around ganglia and vessels expands much more, thus allowing the alcohol-contrast medium solution to spread easily and evenly getting to both celiac ganglia by gravity. The analgesic value of celiac plexus neurolysis has been proved complete and lasting. The technique is quick and safe (apart from inevitable hypotension due to splanchnic vasodilatation).
1991年6月至1992年6月,采用一种新的简化技术进行了12例CT引导下经皮腹腔神经丛毁损术,患者取左侧卧位,经右侧单根腰穿针进针。CT引导使介入放射科医生能够在皮肤上确定最佳进针点,给予穿刺针合适的深度和倾斜度,以避免穿过胸膜、实质组织和血管,并最终检查针尖的正确位置及神经毁损剂的扩散情况。在左侧卧位时,神经节和血管周围的脂肪及疏松结缔组织扩张更为明显,从而使酒精造影剂溶液能够通过重力作用轻松、均匀地扩散至双侧腹腔神经节。腹腔神经丛毁损术的镇痛效果已被证实是完全且持久的。该技术快速且安全(除了因内脏血管扩张不可避免地导致低血压外)。