胸腔镜内脏神经切断术治疗肝癌所致的顽固性疼痛

Treatment of intractable pain caused by liver cancer with thoracoscopic splanchnicectomy

摘要:

目的 探讨胸腔镜内脏神经切断术对肝癌所致的顽固性疼痛的临床疗效。方法 对2007年3月～2011年9月共8例失去手术机会的肝癌所致顽固性腹痛患者进行胸腔镜下左侧内脏神经切断术，术后记录手术持续时间、胸腔引流持续时间及住院时间，术中、术后并发症。观察并记录术前、术后第7天和术后1个月疼痛评分（VAS评分）。记录术后患者镇痛剂使用情况。结果 手术持续时间25～60 min，平均35 min。7例行胸腔闭式引流患者，术后引流管持续时间为2～4 d，平均2.3 d。住院时间5～7 d，平均5.6 d。术前、术后1周及术后1个月患者VAS评分为（8.92±1.06）∶（1.74±0.89）∶（1.95±1.03）。术后患者住院期间全部无需阿片类镇痛药物，其中6例患者不需要任何止痛药。结论 胸腔镜下左侧内脏神经切断术是治疗肝癌性腹痛的一种安全、简单、有效的方法。

Abstract:

【Objective】 To investigate the effect of thoracoscopic splanchnicectomy for managing intractable pain in liver cancer patients. 【Method】 From March 2007 to September 2011, 8 patients with intractable pain of liver cancer were given the left side thoracoscopic splanchnicectomy. The duration and the complication of the operation were observed. The VAS pain scores were measured before the operation and at the 1st day, the 7th day, the 1st month after it. And the using of anodyne was recorded. 【Results】 Duration of surgery was 25～60min, average 35 min. Hospitalization time 5～7d, average 5.6d. The postoperative pain scores at the different time points of the patients were significantly decreased compared with that of preoperative ones. The VAS pain scores at the time of before the operation and at the 7th day, the 1st month after it was （8.92±1.06）, （1.74±0.89）, （1.95±1.03）, respectively. No postoperative patients need opioid analgesics. 6 patients did not need any painkillers. 【Conclusion】 The thoracoscopic splanchnicectomy with sympathectomy is comparatively effective in the treatment of liver cancer pain.