脊柱神经溶解用于由腹腔前列动脉淋巴结转移引起的严重癌症疼痛
Tetsumi Sato1,2, Tetsu Sato3,4, Yoshiko Kamo3,4
1Division of Palliative Medicine, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi-cho, Sunto-gun, Shizuoka, 411-8777, Japan. te.sato@scchr.jp.
概括
脊柱神经神经溶解 (SNN) 有效地减少了阿片类药物的使用和救援剂量在癌症患者严重的腹部和背部疼痛由扩大的前列动脉淋巴结 (PAN). 这种干预性治疗提供了一种安全的选择来管理难治的疼痛.
科学领域:
- 干预性疼痛管理 干预性疼痛管理
- 在瘤学瘤学.
- 抚慰性护理是一种缓解性护理.
背景情况:
- 转移性甲状腺性淋巴结 (PAN) 的扩大会导致严重的腹部和背部疼痛.
- PAN引起的疼痛往往涉及同情神经系统,并且可能对标准的止痛药物有抗性.
- 这就需要探索治疗癌症疼痛的替代疗法.
研究的目的:
- 评估神经神经溶解 (SNN) 治疗难治的腹部和/或背部疼痛的疗效和安全性.
- 为了评估SNN对阿片类药物需求的影响,在患有由于扩大的PAN引起的疼痛的患者中.
主要方法:
- 对接受SNN治疗PAN相关疼痛的癌症疼痛患者的回顾性分析.
- 在X射线光学指导下通过跨盘方法进行SNN.
- 与SNN前后的阿片类药物剂量和救援药物的使用进行了比较.
主要成果:
- 在手术后4周,SNN显著降低了每日阿片类药物剂量 (427毫克至229毫克) 和救援药物频率 (每天4.9至2.3次).
- 在SNN后1周 (p=0.006) 和4周 (p=0.035) 的阿片类药物需求显著下降.
- 在两个患者中,轻度腹是唯一报告的副作用.
结论:
- 脊柱神经神经溶解 (SNN) 是一种有效和安全的干预疗法.
- 通过SNN可显著缓解腹部和背部疼痛的疼痛,这些疼痛是由扩大的PAN引起的.
- 它在晚期癌症患者的息治疗中提供了一种有价值的治疗选择.
相关概念视频
Chemotherapy-Induced Nausea and Vomiting: Neurokinin-1 Receptor Antagonists
147
Neurokinin 1 (NK1) receptors are distributed across the GI tract, vagal afferents, and key CNS regions including the central vomiting center and chemoreceptor trigger zone (CTZ) Chemotherapy agents stimulate enterochromaffin cells in the gastrointestinal (GI) tract to release large amounts of substance P (SP). SP is a neuropeptide released by specific sensory nerves in response to many different stressors, including those in the GI mucosa affected by chemotherapy. SP binds and activates...
147
Local Anesthetics: Clinical Application as Spinal Anesthesia
570
Spinal anesthetics are given during lower abdomen and limb surgeries to block sensory and motor neurons. They are administered in the mid to low lumbar regions, primarily acting on the cauda equina's nerve roots. The blockade level depends on the local anesthetic (LA) concentration. Usually, low LA concentrations are sufficient to block sensory fibers, while only high LA concentrations block motor fibers. Other factors like injection volume and speed, the patient's posture, and the drug...
570


