影像引导下腹腔神经丛毁损术的研究进展
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摘要
腹腔神经丛毁损术(NCPB)常用于治疗上腹部癌症患者的疼痛,其原理是对腹腔神经丛注射神经破坏药以破坏神经,进而达到缓解疼痛的目的。由于腹腔神经丛解剖位置的特殊性,如何精准地注射神经破坏药以提高毁损的成功率及降低并发症的发生率是该领域的研究热点。随着影像技术的不断发展,NCPB的治疗方式及疗效不断提高。本文旨在探讨影像引导下NCPB治疗上腹部顽固性癌痛的研究进展。
Neurolytic celiac plexus block(NCPB) has been performed extensively for severe upper abdominal pain of cancer patients. It alleviates refractory upper abdominal pain by injecting medications causing nerve damage in solar plexus. Due to the special location of the plexus, how to precisely inject nerve damage drugs are essential for improving the success rate of neurolysis and minimizing complications. With the development of imaging technology, the management of NCPB has improved over time. The purpose of this study, therefore, is to review the progress of image-guided NCPB in intractable cancer pain treatment.
Neurolytic celiac plexus block(NCPB) has been performed extensively for severe upper abdominal pain of cancer patients. It alleviates refractory upper abdominal pain by injecting medications causing nerve damage in solar plexus. Due to the special location of the plexus, how to precisely inject nerve damage drugs are essential for improving the success rate of neurolysis and minimizing complications. With the development of imaging technology, the management of NCPB has improved over time. The purpose of this study, therefore, is to review the progress of image-guided NCPB in intractable cancer pain treatment.
引文
[1] Cornman-Homonoff J,Holzwanger DJ,Lee KS,et al.Celiac plexus block and neurolysis in the management of chronic upper abdominal pain[J].Semin Intervent Radiol,2017,34(4):376- 386.
[2] Gunduz O H,Kenis-Coskun O.Ganglion blocks as a treatment of pain:current perspectives[J].J Pain Res,2017,10:2815- 2826.
[3] Yoon DM,Yoon KB,Baek IC,et al.Predictors of analgesic efficacy of neurolytic celiac plexus block in patients with unresectable pancreatic cancer:the importance of timing[J].Support Care Cancer,2018,26(6):2023- 2030.
[4] 周克明,蒋建军,首峰,等.农村癌痛患者临终关怀直接经济负担分析[J].肿瘤预防与治疗,2018,31(1):57- 61.
[5] Lavu H,Lengel HB,Sell NM,et al.A prospective,randomized,double-blind,placebocontrolled trial on the efficacy of ethanol celiac plexus neurolysis in patients with operable pancreatic and periampullary adenocarcinoma[J].J Am Coll Surg,2015,220(4):497- 508.
[6] Teixeira MJ,Neto ER,Da NJ,et al.Celiac plexus neurolysis for the treatment of upper abdominal cancer pain[J].Neuropsychiatr Dis Treat,2013,9:1209- 1212.
[7] Wang D.Image guidance technologies for interventional pain procedures:ultrasound,fluoroscopy,and CT[J].Curr Pain Headache Rep,2018,22(1):6.
[8] Sachdev AH,Gress FG.Celiac plexus block and neurolysis:a review[J].Gastrointest Endosc Clin N Am,2018,28(4):579- 586.
[9] 倪家骧.神经病理性疼痛的微创介入治疗[J].中国康复医学杂志,2012,27(7):671- 674.
[10] Sun X,Xu J,Ni Y,et al.CT-guided consecutive neurolytic celiac plexus block for the management of refractory abdominal neuralgia caused by diabetic neuropathy[J].J VascInterv Radiol,2018,29(10):1474- 1476.
[11] Edelstein MR,Gabriel RT,Elbich JD,et al.Pain outcomes in patients undergoing CT-guided celiac plexus neurolysis for intractable abdominal visceral pain[J].Am J Hosp Palliat Care,2017,34(2):111- 114.
[12] Yabe N,Masuda M,Tamura E,et al.A case of complete response to computed tomography-guided celiac plexus neurolysis of pain associated with postoperative recurrence of colon cancer[J].Gan To Kagaku Ryoho,2018,45(13):1877- 1879.
[13] Patela BN,Giacominib C,Jeffreyc RB,et al.Three-dimensional volume-rendered multidetector CT imaging of the posterior inferior pancreaticoduodenal artery:its anatomy and role in diagnosing extrapancreatic perineural invasion[J].Cancer Imaging,2013,13(4):580- 590.
[14] Bahn BM,Erdek MA.Celiac plexus block and neurolysis for pancreatic cancer[J].Curr Pain Headache Rep,2013,17(2):310.
[15] Rahman A,Rahman R,Macrinici G,et al.Low volume neurolytic retrocrural celiac plexus block for visceral cancer pain:retrospective review of 507 patients with severe malignancy related pain due to primary abdominal cancer or metastatic disease [J].Pain Physician,2018,21(5):497- 504
[16] Warner NS,Trousdale ER,Lamer TJ.Novel single-needle approach for retrocrural celiac plexus blockade using fluoroscopic guidance:a case report[J].AA Pract,2019,12(8):281- 284.
[17] Martin Noguerol T,Barousse R,Socolovsky M,et al.Quantitativemagnetic resonance(MR) neurography for evaluation of peripheralnerves and plexus injuries[J].Quant Imaging Med Surg,2017,7(4):398- 421.
[18] Jeon T,Fung MM,Koch KM,et al.Peripheral nerve diffusion tensorimaging:overview,pitfalls,and future directions[J].J Magn ResonImaging,2018,47(5):1171- 1189.
[19] Zhang XL,Li MZ,Guan J,et al.Evaluation of the sacral nerve plexus in pelvic endometriosis by three-dimensional MR neurography [J].J Magn Reson Imaging,2017,45(4):1225- 1231.
[20] 蒋武,何应科,罗坤,等.内镜超声引导下腹腔神经丛毁损术缓解胰腺癌所致癌性腹痛的效果[J].医学综述,2016,22(20):4094- 4100.
[21] Nagels W,Pease N,Bekkering G,et al.Celiac plexus neurolysis for abdominal cancer pain:a systematic review[J].Pain Med,2013,14(8):1140- 1163.
[22] Kawasoe H,Eguchi Y,Mizuta T,et al.Radiofrequency ablation with the real-time virtual sonography system for treating hepatocellular carcinoma difficult to detect by ultrasonography[J].J Clin Biochem Nutr,2007,40(1):66- 72.
[23] Yasuda I,Wang HP.Endoscopic ultrasound-guided celiac plexus block and neurolysis[J].Dig Endosc,2017,29(4):455- 462.
[24] Sahai AV.EUS-guided celiac ganglia neurolysis versus celiac plexus neurolysis:dying to know which is better[J].Gastrointestinal Endosc,2017,86(4):664- 665.
[25] Cornman-Homonoff J,Holzwanger D,Lee K,et al.Celiac plexus block and neurolysis in the management of chronic upper abdominal pain[J].Semin Intervent Radiol,2017,34(4):376- 386.
[26] Puli SR,Reddy JB,Bechtold ML,et al.EUS-guided celiac plexus neurolysis for pain due to chronic pancreatitis or pancreatic cancer pain:a meta- analysis and systematic review[J].Dig Dis Sci,2009,54(11):2330- 2337.
[27] Arcidiacono PG,Calori G,Carrara S,et al.Celiac plexus block for pancreatic cancer pain in adults[J].Cochrane Database Syst Rev,2011,16(3):D7519.
[28] Tewari S,Agarwal A,Dhiraaj S,et al.Comparative evaluation of retrocrural versus transaortic neurolytic celiac plexus block for pain relief in patients with upper abdominal malignancy:A retrospective observational study[J].Indian J Palliat Care,2016,22(3):301- 306.
[29] Hao SJ,Xu WJ,Yang D,et al.How to improve the efficacy of endoscopic ultrasound-guided celiac plexus neurolysis in pain management in patients with pancreatic cancer:analysis in a single center[J].Surg Laparosc Endosc Percutan Tech,2014,24(1):31- 35.
[30] Catalano MF,Ahmed U,Chauhan SS,et al.Celiac plexus neurolysis (CPN) in the treatment of refractory pain of pancreatic cancer (PCA):site specific response to therapy[J].Gastrointest Endosc,2005,61(5):AB273.
[31] 蔡昌平,谢兴国,赵琼惠,等.腹腔神经丛的应用解剖[J].川北医学院学报,2003,18(1):5- 7.
[32] Iwata K,Yasuda I,Enya M,et al.Predictive factors for pain relief after endoscopic ultrasound-guided celiac plexus neurolysis[J].Dig Endosc,2011,23(2):140- 145.
[33] Obstein KL,Martins F P,Fernandez-Esparrach G,et al.Endoscopic ultrasound-guided celiac plexus neurolysis using a reverse phase polymer[J].World J Gastroenterol,2010,16(6):728- 731.
[34] Leblanc JK,Dewitt J,Johnson C,et al.A prospective randomized trial of 1 versus 2 injections during EUS-guided celiac plexus block for chronic pancreatitis pain[J].Gastrointest Endosc,2009,69(4):835- 842.
[35] 付霜,曲丕盛,方军,等.连续膈肌脚后间隙阻滞治疗顽固性上腹部癌痛疗效观察[J].中国康复医学杂志,2015,30(3):260- 264.
[36] Koker IH,Aralasmak A,Unver N,et al.Spinal cord ischemia after endoscopic ultrasound guided celiac plexus neurolysis:case report and review of the literature[J].Scand J Gastroenterol,2017,52(10):1158- 1161.
[37] Minaga K,Kitano M,Imai H,et al.Acute spinal cord infarction after EUS-guided celiac plexus neurolysis[J].Gastrointest Endosc,2016,83(5):1039- 1040.
[2] Gunduz O H,Kenis-Coskun O.Ganglion blocks as a treatment of pain:current perspectives[J].J Pain Res,2017,10:2815- 2826.
[3] Yoon DM,Yoon KB,Baek IC,et al.Predictors of analgesic efficacy of neurolytic celiac plexus block in patients with unresectable pancreatic cancer:the importance of timing[J].Support Care Cancer,2018,26(6):2023- 2030.
[4] 周克明,蒋建军,首峰,等.农村癌痛患者临终关怀直接经济负担分析[J].肿瘤预防与治疗,2018,31(1):57- 61.
[5] Lavu H,Lengel HB,Sell NM,et al.A prospective,randomized,double-blind,placebocontrolled trial on the efficacy of ethanol celiac plexus neurolysis in patients with operable pancreatic and periampullary adenocarcinoma[J].J Am Coll Surg,2015,220(4):497- 508.
[6] Teixeira MJ,Neto ER,Da NJ,et al.Celiac plexus neurolysis for the treatment of upper abdominal cancer pain[J].Neuropsychiatr Dis Treat,2013,9:1209- 1212.
[7] Wang D.Image guidance technologies for interventional pain procedures:ultrasound,fluoroscopy,and CT[J].Curr Pain Headache Rep,2018,22(1):6.
[8] Sachdev AH,Gress FG.Celiac plexus block and neurolysis:a review[J].Gastrointest Endosc Clin N Am,2018,28(4):579- 586.
[9] 倪家骧.神经病理性疼痛的微创介入治疗[J].中国康复医学杂志,2012,27(7):671- 674.
[10] Sun X,Xu J,Ni Y,et al.CT-guided consecutive neurolytic celiac plexus block for the management of refractory abdominal neuralgia caused by diabetic neuropathy[J].J VascInterv Radiol,2018,29(10):1474- 1476.
[11] Edelstein MR,Gabriel RT,Elbich JD,et al.Pain outcomes in patients undergoing CT-guided celiac plexus neurolysis for intractable abdominal visceral pain[J].Am J Hosp Palliat Care,2017,34(2):111- 114.
[12] Yabe N,Masuda M,Tamura E,et al.A case of complete response to computed tomography-guided celiac plexus neurolysis of pain associated with postoperative recurrence of colon cancer[J].Gan To Kagaku Ryoho,2018,45(13):1877- 1879.
[13] Patela BN,Giacominib C,Jeffreyc RB,et al.Three-dimensional volume-rendered multidetector CT imaging of the posterior inferior pancreaticoduodenal artery:its anatomy and role in diagnosing extrapancreatic perineural invasion[J].Cancer Imaging,2013,13(4):580- 590.
[14] Bahn BM,Erdek MA.Celiac plexus block and neurolysis for pancreatic cancer[J].Curr Pain Headache Rep,2013,17(2):310.
[15] Rahman A,Rahman R,Macrinici G,et al.Low volume neurolytic retrocrural celiac plexus block for visceral cancer pain:retrospective review of 507 patients with severe malignancy related pain due to primary abdominal cancer or metastatic disease [J].Pain Physician,2018,21(5):497- 504
[16] Warner NS,Trousdale ER,Lamer TJ.Novel single-needle approach for retrocrural celiac plexus blockade using fluoroscopic guidance:a case report[J].AA Pract,2019,12(8):281- 284.
[17] Martin Noguerol T,Barousse R,Socolovsky M,et al.Quantitativemagnetic resonance(MR) neurography for evaluation of peripheralnerves and plexus injuries[J].Quant Imaging Med Surg,2017,7(4):398- 421.
[18] Jeon T,Fung MM,Koch KM,et al.Peripheral nerve diffusion tensorimaging:overview,pitfalls,and future directions[J].J Magn ResonImaging,2018,47(5):1171- 1189.
[19] Zhang XL,Li MZ,Guan J,et al.Evaluation of the sacral nerve plexus in pelvic endometriosis by three-dimensional MR neurography [J].J Magn Reson Imaging,2017,45(4):1225- 1231.
[20] 蒋武,何应科,罗坤,等.内镜超声引导下腹腔神经丛毁损术缓解胰腺癌所致癌性腹痛的效果[J].医学综述,2016,22(20):4094- 4100.
[21] Nagels W,Pease N,Bekkering G,et al.Celiac plexus neurolysis for abdominal cancer pain:a systematic review[J].Pain Med,2013,14(8):1140- 1163.
[22] Kawasoe H,Eguchi Y,Mizuta T,et al.Radiofrequency ablation with the real-time virtual sonography system for treating hepatocellular carcinoma difficult to detect by ultrasonography[J].J Clin Biochem Nutr,2007,40(1):66- 72.
[23] Yasuda I,Wang HP.Endoscopic ultrasound-guided celiac plexus block and neurolysis[J].Dig Endosc,2017,29(4):455- 462.
[24] Sahai AV.EUS-guided celiac ganglia neurolysis versus celiac plexus neurolysis:dying to know which is better[J].Gastrointestinal Endosc,2017,86(4):664- 665.
[25] Cornman-Homonoff J,Holzwanger D,Lee K,et al.Celiac plexus block and neurolysis in the management of chronic upper abdominal pain[J].Semin Intervent Radiol,2017,34(4):376- 386.
[26] Puli SR,Reddy JB,Bechtold ML,et al.EUS-guided celiac plexus neurolysis for pain due to chronic pancreatitis or pancreatic cancer pain:a meta- analysis and systematic review[J].Dig Dis Sci,2009,54(11):2330- 2337.
[27] Arcidiacono PG,Calori G,Carrara S,et al.Celiac plexus block for pancreatic cancer pain in adults[J].Cochrane Database Syst Rev,2011,16(3):D7519.
[28] Tewari S,Agarwal A,Dhiraaj S,et al.Comparative evaluation of retrocrural versus transaortic neurolytic celiac plexus block for pain relief in patients with upper abdominal malignancy:A retrospective observational study[J].Indian J Palliat Care,2016,22(3):301- 306.
[29] Hao SJ,Xu WJ,Yang D,et al.How to improve the efficacy of endoscopic ultrasound-guided celiac plexus neurolysis in pain management in patients with pancreatic cancer:analysis in a single center[J].Surg Laparosc Endosc Percutan Tech,2014,24(1):31- 35.
[30] Catalano MF,Ahmed U,Chauhan SS,et al.Celiac plexus neurolysis (CPN) in the treatment of refractory pain of pancreatic cancer (PCA):site specific response to therapy[J].Gastrointest Endosc,2005,61(5):AB273.
[31] 蔡昌平,谢兴国,赵琼惠,等.腹腔神经丛的应用解剖[J].川北医学院学报,2003,18(1):5- 7.
[32] Iwata K,Yasuda I,Enya M,et al.Predictive factors for pain relief after endoscopic ultrasound-guided celiac plexus neurolysis[J].Dig Endosc,2011,23(2):140- 145.
[33] Obstein KL,Martins F P,Fernandez-Esparrach G,et al.Endoscopic ultrasound-guided celiac plexus neurolysis using a reverse phase polymer[J].World J Gastroenterol,2010,16(6):728- 731.
[34] Leblanc JK,Dewitt J,Johnson C,et al.A prospective randomized trial of 1 versus 2 injections during EUS-guided celiac plexus block for chronic pancreatitis pain[J].Gastrointest Endosc,2009,69(4):835- 842.
[35] 付霜,曲丕盛,方军,等.连续膈肌脚后间隙阻滞治疗顽固性上腹部癌痛疗效观察[J].中国康复医学杂志,2015,30(3):260- 264.
[36] Koker IH,Aralasmak A,Unver N,et al.Spinal cord ischemia after endoscopic ultrasound guided celiac plexus neurolysis:case report and review of the literature[J].Scand J Gastroenterol,2017,52(10):1158- 1161.
[37] Minaga K,Kitano M,Imai H,et al.Acute spinal cord infarction after EUS-guided celiac plexus neurolysis[J].Gastrointest Endosc,2016,83(5):1039- 1040.