对已发表的研究进行系统回顾和荟萃分析,以评估计算机断层扫描(CT)引导的单腹腔神经丛神经溶解(CPN)并在一次会议中将神经溶解剂注入腹腔神经丛(CT引导的单CPN)的镇痛疗效和安全性。
PubMed,Cochrane图书馆,和Ichushi-Web搜索了截至2022年2月发表的英文或日文文章,这些文章报道了接受CT引导的单CPN患者的发现.在系统评价和荟萃分析中评估的结果指标是干预前后0至10的疼痛测量量表以及次要和主要并发症的发生率。
干预前和1-或2-的汇总疼痛测量量表,7-,30-,60-,90-,干预后180天为6.72(95%置信区间[CI],4.77-9.46,I2=98%),2.31(95%CI2.31-4.44,I2=92%),2.84(95%CI1.39-5.79,I2=95%),3.36(95%CI1.66-6.77,I2=98%),3.19(95%CI1.44-7.08,I2=59%),3.87(95%CI1.88-7.97,I2=0%),和3.40(95%CI3.02-3.83,I2=不适用),分别。合并的腹泻的轻微并发症发生率,低血压,恶心或呕吐,与手术相关的疼痛为18%(95%CI8-37%,I2=45%),16%(95%CI2-58%,I2=76%),6%(95%CI2-16%,I2=1%),和7%(95%CI2-21%,I2=17%),分别。在纳入的研究中没有重大并发症。
CT引导的单CPN可以安全地进行并提供即时的镇痛功效,尽管异质性的量被表征为大。需要进一步研究其长期镇痛效果。
To perform a systematic review and meta-analysis of published studies to evaluate the analgesic efficacy and safety of computed tomography (CT)-guided single celiac plexus neurolysis (CPN) with the injection of a neurolytic agent into the celiac plexus in one session (CT-guided single CPN).
PubMed, the Cochrane Library, and Ichushi-Web were searched for English or Japanese articles published up to February 2022, which reported findings about patients who underwent CT-guided single CPN. The outcome measures assessed in the systematic review and meta-analysis were the pain measurement scales from 0 to 10 before and after the intervention and the rate of minor and major complications.
The pooled pain measurement scales at pre-intervention and 1- or 2-, 7-, 30-, 60-, 90-, and 180-day post-intervention was 6.72 (95% confidence interval [CI], 4.77-9.46, I2 = 98%), 2.31 (95% CI 2.31-4.44, I2 = 92%), 2.84 (95% CI 1.39-5.79, I2 = 95%), 3.36 (95% CI 1.66-6.77, I2 = 98%), 3.19 (95% CI 1.44-7.08, I2 = 59%), 3.87 (95% CI 1.88-7.97, I2 = 0%), and 3.40 (95% CI 3.02-3.83, I2 = not applicable), respectively. The pooled minor complication rates of diarrhea, hypotension, nausea or vomiting, and pain associated with the procedure were 18% (95% CI 8-37%, I2 = 45%), 16% (95% CI 2-58%, I2 = 76%), 6% (95% CI 2-16%, I2 = 1%), and 7% (95% CI 2-21%, I2 = 17%), respectively. There was no major complication in the included studies.
CT-guided single CPN can be performed safely and provides immediate analgesic efficacy although the amount of heterogeneity is characterized as large. Further investigation of its long-term analgesic efficacy is required.