中国普通外科杂志2016，Vol.25Issue(7)：979-984,6.DOI:10.3978/j.issn.1005-6947.2016.07.008
局麻下CT引导肝癌微波消融术中肿瘤位置与疼痛的关系
Relationship between tumor location and intraoperative pain during CT-guided microwave ablation under local anesthesia
谢冕 1王钊 2贺银 1李科3
作者信息
- 1. 重庆市中医院麻醉科，重庆 400021
- 2. 重庆市中医院腹部外科，重庆 400021
- 3. 遵义医学院附属医院 麻醉科，贵州 遵义 563000
- 折叠
摘要
Abstract
Objective: To investigate the relationship between the distance of lesions of liver cancer from the liver capsule or subsegmental portal vein branches and intraoperative pain during CT-guided microwave ablation (MWA) under local anesthesia. <br> Methods: Seventy-eight patients with liver cancer undergoing MWA treatment following successful hepatic arterial chemoembolization were selected. According to the primary location of the lesions, they were divided into proximal group (distance between lesions and the liver capsule or subsegmental portal vein branches less than or equal to 5 cm, 32 cases and 37 lesions), and distal group (distance between lesions and the liver capsule or subsegmental portal vein branches more than 5 cm, 46 cases and 54 lesions). hTe differences of treatment effcacy, degree of intra-procedural pain and other variables between the two groups were compared. <br> Results: hTe difference in complete tumor ablation rate between proximal group and distal group had no statistical signiifcance (75.86%vs. 81.48%,P>0.05). hTe AFP levels in both groups were signiifcantly reduced compared with preoperative values (bothP<0.05), but no signiifcant inter-group difference was noted (P>0.05). Stratiifed comparison according to tumor size (≤2 cm and >2 cm) showed that there was no signiifcant difference in VAS score, maximum tolerable dose, and ablation time between the two groups (allP>0.05), but the intraoperative VAS score, relative VAS value and dose of pethidine requirement in proximal group were signiifcantly higher than those in distal group (allP<0.05); the intraoperative VAS score, ablation time and dose of pethidine requirement of patients with tumor size >2 cm in either proximal group or distal group were signiifcantly higher than those of patients with tumor size ≤2 cm (allP<0.05). <br> Conclusion: Pain perception is increased during MWA treatment in liver cancer patients with distance between lesion and the liver capsule or subsegmental portal vein branches ≤5 cm and is especially more obvious in those with tumor diameter larger than 2 cm.关键词
肝肿瘤/消融技术/疼痛Key words
Liver Neoplasms/Ablation Techniques/Pain分类
医药卫生引用本文复制引用
谢冕,王钊,贺银,李科..局麻下CT引导肝癌微波消融术中肿瘤位置与疼痛的关系[J].中国普通外科杂志,2016,25(7):979-984,6.
