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晚期癌痛患者17例,男9例,女8例,年龄46-85岁,体重38-63kg,VASⅢ或Ⅳ级。CT引导下经T12-L1椎间隙左、右穿刺,针尖分别抵达膈脚外腹主动脉旁及膈脚内。分别注入含造影剂(30％碘海醇注射液1 m1)的1％利多卡因8 ml,CT示所注药液有会师趋势或已会师包绕腹主动脉后,左、右分别注入无水酒精20、15 ml,再次CT观察酒精扩散情况,以视觉模拟评分(VAS)及改良生活质量(QOL)评分评价镇痛效果。会师包绕腹主动脉的11例患者中8例(73％)镇痛效果满意至去世;另6例酒精在腹主动脉周围被转移的淋巴结分割呈斑点、斑片状,其中3例(50％)完全无痛。与腹腔丛阻滞(NCPB)前相比,NCPB后各时点的VAS评分下降,QOL评分升高(P<0．01)。双针会师法腹腔丛阻滞可使所注无水酒精在腹腔丛恰当分布,对顽固性上腹部癌痛患者有较好的镇痛效果。
17 patients with advanced cancer pain, 9 males and 8 females, aged 46-85 years old, body weight 38-63kg, VAS Ⅲ or Ⅳ grade. CT guided by T12-L1 intervertebral space left and right puncture, the tip of the diaphragm were reached outside the abdominal aorta and phrenic feet. Were injected with contrast agent (30% iohexol injection 1ml) of 1% lidocaine 8ml, CT showed that the injection of liquid have a tendency to be met or have been wrapped around the abdominal aorta, left and right were injected without Water alcohol 20,15 ml, again CT observation of alcohol diffusion, visual analogue scale (VAS) and improved quality of life (QOL) score evaluation of analgesic effect. Eight of the 11 patients (73%) who were involved in the abdominal aorta were satisfied with their analgesic effect and died of the pain. The other six cases were spotted and patchy in lymph nodes that were metastasized around the abdominal aorta. Three of them (50 %) Completely painless. Compared with pre-celiac plexus block (NCPB), VAS score decreased and QOL score increased at each time point after NCPB (P <0.01). Double needle assembly method of abdominal plexus block can make note of anhydrous ethanol in the abdominal cavity proper distribution, refractory upper abdominal cancer pain patients have better analgesic effect.