Anterior cingulotomy improves malignant mesothelioma pain and dyspnoea
Anterior cingulotomy improves malignant mesothelioma pain and dyspnoea
复制标题
DOI：
10.3109/02688697.2013.857006
复制
发表时间：
2014-08-01
影响因子：
1.1
通讯作者：
Aziz, Tipu Z.
中科院分区：
文献类型：
--
作者：
Pereira, Erlick A. C.;Paranathala, Menaka;Aziz, Tipu Z.
背景双侧前扣带回切开术是偶尔用于癌症疼痛的姑息性手术，人体研究表明前扣带回皮质在呼吸困难状态下是活跃的。目标.一例因恶性间皮瘤缓解双侧前扣带回切开术胸壁疼痛衰弱和呼吸困难的变化进行了调查。结果术后2个月观察到疼痛、呼吸困难和任一症状困扰患者的程度的改善，之后疾病进展导致术后5个月死亡。术后2个月的生活质量也有所改善，从手术到死亡疼痛持续缓解。动脉血气和肺功能测试未发生变化，表明通过扣带回切开术减少了疼痛和呼吸困难意识。结论.双侧扣带回前部切开术有效缓解了疼痛和呼吸困难。前扣带皮层在疼痛和自主呼吸控制的作用进行了讨论，旁边的证据，这种姑息程序的癌症疼痛。
Background. Bilateral anterior cingulotomy is a palliative procedure occasionally used for cancer pain, and human studies suggest anterior cingulate cortex is active in dyspnoeic states. Objectives. A case of debilitating thoracic wall pain due to malignant mesothelioma relieved by bilateral anterior cingulotomy is described and changes in dyspnoea investigated. Results. Improvements in pain, dyspnoea and the extent to which either symptom bothered the patient was seen for 2 months after surgery before disease progression led to death 5 months after surgery. Quality of life improvements were also seen for 2 months after surgery and pain relief was sustained from surgery to death. Arterial blood gas and lung function tests were unchanged by surgery, suggesting a reduction in pain and dyspnoea awareness by cingulotomy. Conclusions. Bilateral anterior cingulotomy effectively relieved both pain and dyspnoea. The role of the anterior cingulate cortex in pain and autonomic control of respiration is discussed alongside the evidence for this palliative procedure for cancer pain.