目的 观察改良肠系膜下神经丛毁损术治疗左下腹晚期癌痛的可行性及疗效.方法 左下腹部晚期癌痛患者36例,随机分为试验组及对照组,试验组18例在CT引导下经蛛网膜下腔及L3～4椎间盘穿刺以无水乙醇行肠系膜下神经丛毁损,对照组18例给予阿片类等药物止痛,两组分别于治疗前,治疗后1 d、1个月、3个月对患者行视觉模拟评分(VAS)评分、口服阿片药日用量、便秘的缓解、生活质量评分及阻滞相关并发症方面的评价.结果 阻滞后治疗组患者VAS、阿片日用量和生活质量评分显著低于对照组,便秘缓解情况显著优于对照组,两组间差异均有统计学意义(P＜0.05),治疗组无明显并发症发生.结论 改良系膜下神经丛毁损治疗顽固性左下腹晚期癌痛可行且安全有效.%Objective To observe the feasibility and curative effect of the neurolytic block of inferior mesenteric plexus for treating left lower quadrant abdominal cancer pain. Methods 36 patients with left lower quadrant abdominal cancer pain were randomly divided into two groups as test group and control group. 18 cases of test group underwent dehydrated alcohol inferior mesenteric plexus damagement via cavitas subarachnoidealis and L3-4 intervertebral disc puncturation under CT-guided. 18 cases in control group were treated with opioid drugs for analgesia. To evaluate the change of VAS score, daily opioid requirement, constipation relief,life quality scale and associated complications of blocks between two groups hefore treatment,1st day ,1st month,3rd month after treatment. Results VAS, daily opioid requirement and life quality scale of test group were significantly lower than control group,and constipation relief of test group was significantly better than control group, there were significant differences between two groups( P ＜ 0. 05 ). There were no obvious complication in test group. Conclusion Modified neurolytic block of inferior mesenteric plexus for treating left lower quadrant ahdominal cancer pain is safe and effective.
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