Fields S
Department of Radiology, Hadassah University Hospital, Jerusalem, Israel.
J Comput Assist Tomogr. 1996 Jan-Feb;20(1):157-60. doi: 10.1097/00004728-199601000-00029.
Retrocrural splanchnic nerve alcohol neurolysis with a CT-guided anterior transortic approach, a new method for splanchnic block alleviation of chronic abdominal pain, is described. Ten patients with chronic abdominal pain requiring narcotic treatment, six with pancreatic carcinoma, one with gastric carcinoma, two with chronic pancreatitis, and one with pain of unknown etiology, were referred for splanchnic nerve neurolysis. With CT guidance, a 20 gauge needle was placed through the aorta into the retrocrural space at T11-T12, and 5-15 ml 96% alcohol was injected into the retrocrural space. Following the procedure, 6 of 10 patients were pain free, 2 patients had temporary pain relief, and 2 patients were without response. There were no significant complications. CT-guided anterior transaortic retrocrural splanchnic nerve alcohol neurolysis is technically feasible, easier to perform than the classic posterolateral approach, and may have less risk of complications. The success rate in this initial trial was reasonable and, therefore, this technique provides an additional method for the treatment of abdominal pain.
描述了一种采用CT引导下经主动脉前方入路进行膈脚后内脏神经酒精溶解术，这是一种缓解慢性腹痛的内脏神经阻滞新方法。10例需要使用麻醉剂治疗的慢性腹痛患者被转诊进行内脏神经溶解术，其中6例患有胰腺癌，1例患有胃癌，2例患有慢性胰腺炎，1例病因不明的疼痛患者。在CT引导下，将一根20号针经主动脉插入T11 - T12水平的膈脚后间隙，向膈脚后间隙注入5 - 15毫升96%的酒精。术后，10例患者中有6例疼痛消失，2例患者疼痛暂时缓解，2例患者无反应。无明显并发症。CT引导下经主动脉前方膈脚后内脏神经酒精溶解术在技术上是可行的，比经典的后外侧入路更容易操作，且并发症风险可能更小。在这项初步试验中的成功率是合理的，因此，这项技术为腹痛治疗提供了一种额外的方法。
