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首页> 外文期刊>The clinical journal of pain >Computed tomography-guided anterior approach to the superior hypogastric plexus for noncancer pelvic pain: a report of two cases.
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Computed tomography-guided anterior approach to the superior hypogastric plexus for noncancer pelvic pain: a report of two cases.

机译：CT断层扫描引导下腹上神经丛前路治疗非癌性骨盆痛：两例报道。

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摘要

The objective of this study was to evaluate the possibility and describe the methodology of a computed tomography-guided anterior approach to superior hypogastric plexus block for noncancer pain. A computed tomography-guided anterior approach to the superior hypogastric plexus was used in 2 patients with pelvic pain and anatomic disturbance of the lumbar spine, which was a contraindication to the conventional dorsal approach. The first case was a 43-year-old patient suffering from burning pain of the urethra. Pain relief using analgesics and antidepressants was insufficient. The posterior approach was excluded due to coexisting irritation of the L5 nerve root. The second case was a 68-year-old man suffering from chronic burning and itching pain of the urethra and glans penis. Conservative therapy (anti-inflammatory drugs, tramadol, spasmolytics) failed to provide satisfactory pain relief. The posterior approach was contraindicated because of laterally prominent L5 vertebral body osteophytes. Both patients received a prognostic block to the superior hypogastric plexus via the anterior approach guided by computed tomography. Visual analog scale scores prior to the block were 6 to 7 and 5 to 6, respectively. The visual analog scale scores 24 hours after the block were 1 and 0, respectively. The second patient received a permanent neurolytic block via the anterior approach to provide long-term pain relief. In conclusion, the authors describe the computed tomography-guided anterior approach to the superior hypogastric plexus for chronic pelvic pain. The technique is simple to perform, and the analgesic effect is satisfactory. More extensive studies are necessary to evaluate the safety of this approach.
机译：这项研究的目的是评估可能性，并描述一种以计算机断层扫描为指导的前路下腹神经丛阻滞治疗非癌性疼痛的方法。 2例骨盆疼痛且腰椎解剖功能不佳的患者采用计算机断层扫描引导下胃上神经丛前路入路，这是常规背侧入路的禁忌证。第一例是一名43岁的患者，患有尿道灼痛。使用止痛药和抗抑郁药缓解疼痛是不够的。由于同时存在L5神经根刺激，因此排除了后路入路。第二例是一名68岁男子，患有尿道和龟头阴茎的慢性灼痛和瘙痒。保守疗法（消炎药，曲马多，解痉药）未能提供令人满意的止痛效果。由于侧向突出的L5椎骨骨赘，禁忌后路入路。两名患者均通过计算机断层扫描引导下的前路入路接受了下胃下神经丛的预后阻滞。阻止之前的视觉模拟量表评分分别为6到7和5到6。阻断后24小时的视觉模拟量表评分分别为1和0。第二名患者通过前路入路接受了永久性神经溶解阻滞，以提供长期的疼痛缓解。总之，作者描述了计算机断层扫描引导的前入路治疗慢性盆腔痛的上下腹神经丛。该技术操作简单，镇痛效果满意。为了评估这种方法的安全性，需要进行更广泛的研究。

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