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目的评价CT引导下弯针穿刺技术在腹腔神经丛阻滞止痛中的应用价值。方法32例晚期癌症患者,其中13例伴有后腹膜淋巴结广泛肿大并融合成团。所有病例均为顽固性上腹部疼痛,采用麻醉类止痛药治疗及放射治疗,止痛效果均不佳。应用CT引导下弯针穿刺腹腔神经丛阻滞方法进行治疗。结果治疗后即刻、2周、4周、8周、12周、16周的止痛有效率分别为100%、100%、96.9%、90.6%、87.5%、84.4%。肿大淋巴结均有明显坏死缩小。结论联合应用双侧膈脚前、后阻滞及穿入淋巴结内阻滞疗法可取得较好的止痛效果,弯针穿刺技术使阻滞止痛更加简便。
Objective To evaluate the value of curved needle aspiration guided by CT in the prevention and treatment of celiac plexus block. Methods 32 cases of advanced cancer patients, including 13 cases of retroperitoneal lymph nodes extensive swelling and fusion into a group. All cases were refractory upper abdominal pain, the use of narcotic painkillers and radiation therapy, analgesic effect is not good. CT-guided curved needle puncture celiac plexus block method for treatment. Results The immediate analgesic efficiencies of two weeks, four weeks, eight weeks, 12 weeks and 16 weeks after treatment were 100%, 100%, 96.9%, 90.6%, 87.5% and 84.4%, respectively. Enlarged lymph nodes were significantly reduced necrosis. Conclusion Combined application of bilateral anteroplasty anterior and posterior block and penetration of lymph node block therapy can achieve better analgesic effect, the needle puncture technique makes the block and analgesic easier.