实时虚拟导航引导下经皮腹腔神经丛阻滞的临床应用

发布时间：2019-05-06 07:11

【摘要】：目的：本研究旨在分析研究并评价实时虚拟导航系统在经皮腹腔神经丛阻滞术中应用的可行性、安全性以及临床疗效。方法：自2013年05月至2014年05月,本课题对41例患有中上腹部恶性肿瘤伴腹、背部剧烈疼痛的患者施行实时虚拟导航引导下经皮腹腔神经丛阻滞术,所有患者均经过常规镇痛方案治疗无效,其中22例患者为常规超声靶区结构显示欠清晰患者。采用视觉模拟评分法(VAS评分)收集并对比患者术前及术后第1天、7天、30天、90天的疼痛评分,评价临床疗效并记录相关并发症,综合评价实时虚拟导航引导下的经皮腹腔神经丛阻滞术在癌性腹痛治疗中的临床效果。结果：所有患者均顺利完成实时虚拟导航引导下经皮腹腔神经丛阻滞术,术后第1天、7天、30天、90天的视觉模拟评分值均明显低于治疗前,差异均具有统计学意义(P1.05)；疼痛控制的总有效率随着时间的增加呈逐渐下降的趋势。本组病例中除1例急性胰腺炎患者外其他病例无严重并发症发生。结论：实时虚拟导航系统应用于经皮腹腔神经丛阻滞术具有穿刺精准性、安全性、微创伤以及并发症少等优点,尤其对于常规超声靶区结构显示困难患者更有意义,是安全可行的。
[Abstract]:Aim: to study and evaluate the feasibility, safety and clinical effect of real-time virtual navigation system in percutaneous celiac plexus obstruction. Methods: from May 2013 to May 2014, 41 patients with malignant tumors of the middle and upper abdomen and severe pain in the back were treated with real-time virtual navigation guided percutaneous celiac plexus obstruction. All patients were treated with conventional analgesia regimen, 22 of them were patients with unclear ultrasound target structure. Visual analogue scale (VAS) was used to collect and compare the pain scores before operation and on day 1, day 7, day 30, day 90 after the operation, to evaluate the clinical efficacy and to record the related complications. To evaluate the clinical effect of percutaneous celiac plexus block guided by real-time virtual navigation in the treatment of carcinomatous abdominal pain. Results: all patients successfully completed the real-time virtual navigation-guided percutaneous celiac plexus obstruction. The visual analogue scores on day 1, day 7, day 30, day 90 after operation were significantly lower than those before treatment. The difference was statistically significant (P1.05). The total effective rate of pain control decreased gradually with the increase of time. There were no serious complications except one case of acute pancreatitis. Conclusion: the application of real-time virtual navigation system in percutaneous celiac plexus obstruction has the advantages of precision, safety, minimal trauma and less complications, especially for patients with difficulty in displaying the structure of ultrasound target. It is safe and feasible.
【学位授予单位】：山东大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R445.1;R688

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