摘要
目的探讨电视胸腔镜胸交感神经切断术(ETS)各种术式治疗手汗症的疗效和预防并发症的经验。方法我院2003年1月至2007年5月共施行588例 ETS,按不保留胸2交感神经干(T_2)和保留 T_2分为 A、B 两组,对两组患者的临床资料进行回顾性分析。结果全组患者均在胸腔镜下完成手术,无手术死亡和严重并发症。全组患者手掌和头面部多汗症状治疗有效率达99.8%,腋窝和足底多汗症状的缓解率分别达84.0%和71.0%。全组患者随访时间为1～48个月,平均(20.3±2.3)个月。10例术后1周内出现一过性手掌多汗,均在1～3 d 内自行消失;2例术后1～2个月发生味觉性多汗;1例术后8个月单侧手掌多汗症状复发。A 组术后代偿性多汗发生率(28.0%)低于 B 组(13.4%)。结论 ETS 治疗手汗症安全、有效,保留 T_2能降低术后代偿性多汗的发生率。
Objective To evaluate the efficacy of video-assisted thoracoscopic sympathicotomy in the treatment of palmar hyperhidrosis and introduce the clinical experience in the prevention of complications. Methods The clinic data of 588 cases of palmar hyperhidrosis who underwent bilateral sympathicotomy from January 2003 and March 2007 was analyzed retrospectively. The curative results were compared between the T2 levels denervation group （group A） and the T2 levels remained denervation group （group B ）. Results All operations were successfully performed under thoracoscope without severe morbidity and mortality. The curative rate of palmar hyperhidrosis was 99. 8%. Accompanied axillary sweating and plantar sweating were improved in 84. 0% and 71.0% patients respectively. All the patients were evaluated by a follow-up for 1 to 48 months with an average time of （ 20.3 a： 2. 3 ） months on the aspects of curative effect and occurrence of compensatory sweating. During one week after surgery, the transient postoperative hand sweating recurred in 10 cases and then disappeared within 1 to 3 days. Two cases experienced gustatory hyperhidrosis. One case experienced hand sweating at 8 th month postoperative. Sideeffect of compensatory sweating were observed in 28.0 percents of group A and 13.4 percents of group B （ P 〈0.01 ）. Conclusions Video-assisted thoracoscopic sympathicotomy is an effective, safe and minimally invasive method for the treatment of hyperhidrosis. The method of T2 levels remained denervation appears associated with less compensatory sweating.
出处
《中华外科杂志》
CAS
CSCD
北大核心
2007年第22期1527-1529,共3页
Chinese Journal of Surgery
基金
福建省科技厅重点项目基金(2007Y0015)
