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ENGLISH ABSTRACT
腹腔神经丛阻滞疗法中国专家共识（2023版）
王孝文
周华成
徐文坚
刘小会
倪家骧
谢广伦
马常升
侯森林
薛朝霞
杨东
杨晓秋
宋涛
孙涛
夏令杰
何睿林
马柯
陆丽娟
贺永进
万丽
刘广召
作者及单位信息
·
DOI： 10.3760/cma.j.cn101658-20221126-00205
A Chinese experts consensus on celiac plexus block therapy (2023 edition)
Wang Xiaowen
Zhou Huacheng
Xu Wenjian
Liu Xiaohui
Ni Jiaxiang
Xie Guanglun
Ma Changsheng
Hou Senlin
Xue Zhaoxia
Yang Dong
Yang Xiaoqiu
Song Tao
Sun Tao
Xia Lingjie
He Ruilin
Ma Ke
Lu Lijuan
He Yongjin
Wan Li
Liu Guangzhao
Authors Info & Affiliations
Wang Xiaowen
Department of Painology, The Second Hospital of Hebei Medical University, Shijiazhuang City, Hebei Province 050000, China
Zhou Huacheng
Department of Painology, The Fourth Affiliated Hospital of Harbin Medical University, Harbin City, Heilongjiang Province 150001, China
Xu Wenjian
Department of Radiology, Affiliated Hospital of Qingdao University, Qingdao City, Shandong Province 266003, China
Liu Xiaohui
Department of Painology, The Second Hospital of Hebei Medical University, Shijiazhuang City, Hebei Province 050000, China
Ni Jiaxiang
Department of Painology, Xuanwu Hospital of Capital Medical University, Beijing City 100053, China
Xie Guanglun
Department of Pain & Rehabilitation and Palliative Medicine, Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou City, Henan Province 450008, China
Ma Changsheng
Department of Human Anatomy, Hebei Medical University, Shijiazhuang City, Hebei Province 050017, China
Hou Senlin
Department of Bilio-Pancreatic Endoscopic Surgery, The Second Hospital of Hebei Medical University, Shijiazhuang City, Hebei Province 050000, China
Xue Zhaoxia
Department of Painology, The First Hospital of Shanxi Medical University, Taiyuan City, Shanxi Province 030001, China
Yang Dong
Department of Pain Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan City, Hubei Province 430022, China
Yang Xiaoqiu
Department of Painology, The First Affiliated Hospital of Chongqing Medical University, Chongqing City 400016, China
Song Tao
Department of Painology, The First Hospital of China Medical University, Shenyang City, Liaoning Province 110001, China
Sun Tao
Department of Pain Medicine, Provincial Hospital Affiliated to Shandong First Medical University, Jinan City, Shandong Province 250021, China
Xia Lingjie
Department of Pain Medicine, Henan Provincial People's Hospital, Zhengzhou City, Henan Province 450003, China
He Ruilin
Department of Painology, The Second Affiliated Hospital of Guangxi Medical University, Nanning City, Guangxi Zhuang Automomous Region 530007, China
Ma Ke
Department of Pain Medicine, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai City 200092, China
Lu Lijuan
Department of Painology, Nanjing Gulou Hospital, Nanjing City, Jiangsu Province 210008, China
He Yongjin
Department of Painology, Tianjin First Central Hospital, Tianjin City 300192, China
Wan Li
Department of Painology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou City, Guangdong Province 510260, China
Liu Guangzhao
Department of Painology, The Second Hospital of Hebei Medical University, Shijiazhuang City, Hebei Province 050000, China
·
DOI： 10.3760/cma.j.cn101658-20221126-00205
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摘要

腹腔神经丛阻滞（CPB）是治疗上腹部癌如胰腺癌引起腹痛的有效介入技术。腹腔神经丛毁损术能长时间减轻疼痛，减少阿片类药物用量，并降低其药物不良反应。本专家共识参考近几年腹腔神经丛阻滞的进展，就腹腔神经丛阻滞疗法相关的解剖学、适应证、禁忌证、各种操作技术以及并发症作一归纳，形成了腹腔神经丛阻滞疗法的中国专家共识，旨在指导临床应用。

腹腔神经丛;内脏神经;神经传导阻滞;神经毁损;乙醇;癌痛;专家共识
ABSTRACT

Celiac plexus block (CPB) is an effective interventional technique for treatment of abdominal pain caused by upper abdominal cancer, such as pancreatic cancer. Celiac plexus neurolysis can diminish pain for a long time, reduce the opiate requirements, furthermore limit the side effects of the drugs. This expert consensus refers to the progress of CPB in recent years, and summarizes the anatomy, indications, contraindications, various operating techniques, and complications related to CPB, to guide the clinical practice.

Celiac plexus;Splanchnic nerve;Nerve block;Neurolysis;Alcohol;Cancer pain;Expert consensus
Liu Guangzhao, Email: mocdef.aabnis001oahzgnauguil;
Wang Xiaowen, Email: mocdef.3ab6106wxgnaw

All authors are contributed equally to the article

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引用本文

王孝文,周华成,徐文坚,等. 腹腔神经丛阻滞疗法中国专家共识（2023版）[J]. 中华疼痛学杂志,2023,19(03)：356-372.

DOI:10.3760/cma.j.cn101658-20221126-00205

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前言
腹腔神经丛（celiac plexus, CP）将上腹部脏器痛觉冲动传至中枢。腹腔神经丛阻滞（celiac plexus block, CPB）是将局麻药或神经破坏药注射到CP周围，阻断脏器的痛觉传导，从而减轻患者腹痛。Kappis于1914年首次采用经皮后入路法实施腹腔神经丛阻滞麻醉。1957年，Jones首次使用乙醇（alcohol）行腹腔神经丛和内脏神经毁损治疗胰腺癌腹痛，获得长期疼痛缓解 [ 1 ]。此后，众多学者报道了在影像引导下应用CPB治疗上腹部癌性疼痛 [ 2 , 3 , 4 , 5 , 6 ]。
CPB或腹腔神经丛毁损术（celiac plexus neurolysis, CPN）已广泛地应用于上腹部癌症以及非癌性疾病引起的腹痛 [ 1 , 2 , 4 , 5 ]。CPN用于癌性腹痛患者，可缓解疼痛、降低阿片类药物用量、减少或减轻药物不良反应 [ 4 , 7 ]。CPN应作为胰腺癌腹痛介入治疗的首选 [ 8 ]。虽然国内外有CPB/CPN用于癌性腹痛的报道，但国内至今没有其相关技术规范，本专家共识对CPB基础知识和临床应用作一归纳，根据文献提出最佳操作规范，期冀提高治疗效果，减少并发症，为临床医生正确实施CPB提供指导。
术语"CPB"和"CPN"可以互换使用，区别为作用时间不同。CPB是指用长效局麻药（可加用类固醇）暂时阻断CP疼痛传递；CPN是指用神经毁损药（通常用乙醇或苯酚）长时间破坏CP，有时也称CPN为毁损性CPB [ 1 ]。本专家共识的"腹腔神经丛阻滞疗法"既包括CPB，也包括CPN。另外，本专家共识不包括盲穿和术中直视下CPB或CPN。
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刘广召, Email: mocdef.aabnis001oahzgnauguil;
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王孝文, Email: mocdef.3ab6106wxgnaw
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王孝文,周华成,徐文坚,等.腹腔神经丛阻滞疗法中国专家共识(2023版)[J].中华疼痛学杂志, 2023, 19(3): 356-372. DOI: 10.3760/cma.j.cn101658-20221126-00205.
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