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目的对不能切除的胰腺癌行姑息手术的同时行无水酒精腹腔神经丛阻滞术,观察其镇痛效果、并发症及对生活质量的影响。方法选取122例肿块不能切除、伴消化道梗阻、腹部和/或腰背部癌性疼痛的胰腺癌患者,其中姑息手术加腹腔神经丛阻滞术80例患者归为A组,仅行姑息手术42例患者归为B组,比较两组术后疼痛缓解情况、临床受益反应及术后不良反应。结果A与B组术后2周疼痛完全缓解率分别为52.5%和11.9%,总有效率分别为96%和47.6%;半年疼痛完全缓解率分别为20.7%和0%,总有效率分别为68.9%和11.1%;两者在术后各时间点(2周、1个月、3个月、6个月)之间差异有统计学意义(P<0.05)。A组治疗前后KPS评分比较差异有统计学意义(t=6.864,P<0.05),两组治疗前后KPS评分差值比较亦有统计学意义(t=5.326,P<0.05)。术后两组无严重并发症和手术死亡。结论经腹行腹腔神经丛阻滞术具有直视下定位准确、疼痛缓解满意、安全程度高等优点,能有效改善患者的生活质量。
Objective To observe the analgesic effect, complication and quality of life of patients with unresectable pancreatic cancer by palliative surgery with alcoholic celiac plexus block. Methods A total of 122 patients with unresectable pancreatic cancer with digestive tract obstruction, abdominal and / or low back pain were included in this study. Eighty patients with palliative surgery plus celiac plexus block were classified as Group A and only palliative 42 The patients were classified as group B. The postoperative pain relief, clinical benefit and postoperative adverse reactions were compared between the two groups. Results The pain relief rates of group A and B were 52.5% and 11.9% respectively at 2 weeks after operation. The total effective rates were 96% and 47.6% respectively. The complete response rates of half-year pain were 20.7% and 0%, respectively. The total effective rates were 68.9% and 11.1%, respectively. There was a significant difference between the two groups (P <0.05) at all time points (2 weeks, 1 month, 3 months and 6 months). There was significant difference in KPS score between before and after treatment in group A (t = 6.864, P <0.05). There was also a statistically significant difference in KPS score before and after treatment between two groups (t = 5.326, P <0.05). There were no serious complications and surgical death in the two groups after operation. Conclusions Transabdominal celiac plexus block has the advantages of accurate positioning under direct vision, satisfactory pain relief and high safety, which can effectively improve the quality of life of patients.