摘要：
目的 探讨射频热凝术治疗上肢癌性疼痛的有效性和安全性，并评价其对上肢运动功能的影响。方法 共 56 例以臂丛神经受累为主的上肢癌性疼痛患者分别采用射频热凝术（36 例）和神经阻滞术（20 例），分别于治疗前及治疗后 1、3 和 7 d 采用视觉模拟评分（VAS）评价疼痛程度，记录上肢肌力和术后并发症。结果 射频热凝术组患者 VAS 评分低于（F = 64.406，P = 0.000）、肌力高于（F = 64.405，P = 0.000）神经阻滞术组。与术前相比，射频热凝术组患者术后 1、3 和 7 d VAS 评分降低（t = 25.931，P = 0.000；t = 19.600，P = 0.000；t = 24.817，P = 0.000），而肌力各时间点差异无统计学意义（均 P > 0.05）；神经阻滞术组患者术后 1 和 3 d VAS 评分降低（t = 19.298，P = 0.000；t = 14.918，P = 0.000）、至术后 7 d 恢复至术前水平（P > 0.05），术后 1 d 肌力降低（t = 13.069，P = 0.000）、至术后 3 和 7 d 恢复至术前水平（均 P > 0.05）。两组无一例出现感染、气胸等并发症。结论 射频热凝术治疗上肢癌性疼痛安全、有效，且对上肢运动功能影响较小。
关键词:
疼痛, 顽固性,
肿瘤,
上肢,
运动障碍,
射频热凝（非 MeSH 词）
Abstract:
Objective To investigate the efficacy and safety of temperature-controlled radiofrequency thermocoagulation for the treatment of upper extremity cancer pain, and to evaluate its impact on upper extremity motor function. Methods A total of 56 patients with upper extremity cancer pain who were mainly involved in brachial plexus were treated with radiofrequency thermocoagulation (N = 36) and nerve block (N = 20). Before and 1 d, 3 d and 7 d after treatment, Visual Analogue Scale (VAS) was used to assess the degree of pain, upper extremity strength and complications were recorded. Results Compared with nerve block group, patients in radiofrequency thermocoagulation group had lower VAS scores (F = 64.406, P = 0.000) and higher muscle strength (F = 64.405, P = 0.000). Compared with before treatment, patients in radiofrequency thermocoagulation group had lower VAS scores at 1, 3 and 7 d after surgery (t = 25.931, P = 0.000; t = 19.600, P = 0.000; t = 24.817, P = 0.000). There was no significant difference in muscle strength at each time point (P > 0.05, for all). The VAS scores of patients in nerve block group decreased at 1 and 3 d after surgery (t = 19.298, P = 0.000; t = 14.918, P = 0.000), while returned to preoperative level at 7 d after surgery (P > 0.05); muscle strength decreased 1 d after surgery (t = 13.069, P = 0.000), and returned to preoperative level 3 and 7 d after surgery (P > 0.05, for all). No one suffered from complications such as infection or pneumothorax in 2 groups. Conclusions Radiofrequency thermocoagulation is safe and effective in the treatment of upper extremity cancer pain, and has little effect on upper extremity motor function.
Key words:
Pain, intractable,
Neoplasms,
Upper extremity,
Movement disorders,
Radiofrequency thermocoagulation (not in MeSH)
王英峰, 李玉英, 杨成波, 连吉, 臧燕, 南萍, 张小晓. 射频热凝术治疗上肢癌性疼痛的疗效及其对上肢运动功能的影响[J]. 中国现代神经疾病杂志, 2018, 18(10): 727-730.
WANG Ying-feng, LI Yu-ying, YANG Cheng-bo, LIAN Ji, ZANG Yan, NAN Ping, ZHANG Xiao-xiao. Effect of radiofrequency thermocoagulation on upper extremity cancer pain and its impact on upper extremity motor function[J]. Chinese Journal of Contemporary Neurology and Neurosurgery, 2018, 18(10): 727-730.