文章：

肝门阻滞作为神经内分泌肿瘤经动脉栓塞术的辅助手段：安全性与有效性的回顾性研究

Hepatic Hilar Block as an Adjunct to Transarterial Embolization of Neuroendocrine Tumors: A Retrospective Review of Safety and Efficacy

原文发布日期：29 October 2023

DOI: 10.3390/cancers15215202

类型: Article

开放获取: 是

英文摘要：

Purpose: This study investigates whether hepatic hilar nerve blocks (HHNB) provide safe, effective analgesia in patients with neuroendocrine tumors (NET) treated with transarterial embolization (TAE). Methods: The retrospective study included all NETs treated with TAE or TAE + HHNB from 1/2020 to 8/2022. Eighty-five patients (45 men), mean age 62 years, were treated in 165 sessions (TAE,n= 153; TAE + HHNB,n= 12). For HHNBs, ≤10 mL bupivacaine HCl 0.25% ± 2 mg methylprednisolone were injected under ultrasound guidance. The aims were to assess safety of HHNB and reduction in pain. Groups were compared with Pearson’s chi-squared and Wilcoxon rank sum tests. Logistic regression assessed independent risk factors for pain. Results: No immediate complications from HHNBs were reported. No difference in incidence of major complications between TAE and TAE + HHNB one month post-embolization was observed (7.19% vs. 8.33%,p= 0.895). No differences in mean length of hospital stay after treatment were observed (TAE 2.2 days [95%CI: 1.74–2.56] vs. TAE + HHNB 2.8 days [95%CI: 1.43–4.26];p= 0.174). Post-procedure pain was reported in 88.2% of TAE and 75.0% of TAE + HHNB patients (p= 0.185). HHNB recipients were more likely to use analgesic patches (25.0% vs. 5.88%;p= 0.014). No other differences in analgesic use were observed. Conclusions: HHNBs can safely be performed in patients with NETs. No difference in hospital stays or analgesic drug use was observed. Managing pain after TAE is an important goal; further study is warranted.

摘要翻译： 

目的：本研究旨在探讨肝门神经阻滞（HHNB）能否为接受经动脉栓塞术（TAE）治疗的神经内分泌肿瘤（NET）患者提供安全有效的镇痛。方法：这项回顾性研究纳入了2020年1月至2022年8月期间接受TAE或TAE联合HHNB治疗的所有NET病例。共85例患者（男性45例），平均年龄62岁，总计进行165次治疗（TAE组153次，TAE+HHNB组12次）。HHNB操作在超声引导下注射≤10 mL 0.25%盐酸布比卡因±2 mg甲泼尼龙。研究目标是评估HHNB的安全性及疼痛缓解效果。组间比较采用皮尔逊卡方检验和威尔科克森秩和检验，并通过逻辑回归分析疼痛的独立危险因素。结果：未报告HHNB相关即时并发症。栓塞术后一个月，TAE组与TAE+HHNB组主要并发症发生率无显著差异（7.19% vs. 8.33%，p=0.895）。两组治疗后平均住院时间也无差异（TAE组2.2天[95%CI:1.74–2.56] vs. TAE+HHNB组2.8天[95%CI:1.43–4.26]；p=0.174）。术后疼痛发生率在TAE组为88.2%，TAE+HHNB组为75.0%（p=0.185）。HHNB组患者更倾向于使用镇痛贴剂（25.0% vs. 5.88%；p=0.014），其他镇痛药物使用情况无组间差异。结论：HHNB可安全用于NET患者，未观察到住院时间或镇痛药物使用的显著差异。控制TAE术后疼痛是重要目标，值得进一步研究。

原文链接：

Hepatic Hilar Block as an Adjunct to Transarterial Embolization of Neuroendocrine Tumors: A Retrospective Review of Safety and Efficacy