摘要
目的探讨胸腔镜下R2-4及R2-3交感神经链切断术治疗手汗症术后患者满意度差异性及相关因素分析。方法 2008年8月至2010年8月116例严重手汗症患者行手术治疗,患者随机分为两组,行胸腔镜下R2-4交感神经链切断术称为R2-4组,行胸腔镜下R3-4交感神经链切断术称为R3-4组。所有患者均在气管内静吸复合麻醉、胸腔镜下行双侧交感神经链切断术,术后通过电话问卷方式对患者进行随访,评价手术疗效、副作用。结果所有患者术后手汗症状得到解决,术后两组患者生活质量评分表得分均明显降低,但两组患者之间术前及术后1个月、6个月和12个月评分均无明显差异(P=0.859,0.056,0.229,0.367)。单因素分析表明严重代偿性多汗与患者满意度在术后1个月、6个月和12个月均呈负相关(P=0.000,0.000,0.000)。术后1个月仅患者家族史与满意度相关(P=0.019),术后6个月及术后12个月患者年龄、性别、病史、体重指数和不同切除平面均与患者满意度不相关(P>0.05)。结论胸腔镜下R2-4及R2-3交感神经链切断术均是治疗手汗症安全有效的方法。降低交感神经链切除平面或减少切除范围不能增加患者满意度;术后严重代偿性多汗与术后患者满意度成负相关,家族史可能和术后患者满意度相关。
Objective To compared the degree of patient satisfaction from sympathectomies performed to treat severe palmar hyperhidrosis using two distinct levels： R2-4 and R3-4. Methods A total of 116 patients with primary palmar hyperhidrosis were randomly allocated to either an R2-4 sympathectomy treatment （group R2-4） or an R3 - 4 sympathetic treatment （group R3 - 4）. The patients underwent bilateral endoscopic thoracic sympathectomy by cautery. Follow-up data were collected using a telephone questionnaire to assess efficacy, side effects and factors influencing compensatory sweating. Results All sympathectomies were successful and there were no recurrences within 12 months of follow-up. The total scores on the quality-of-life questionnaires after surgery in the two groups were remarkably decreased, but no significant difference was found between the two groups before surgery （P=0.859） and at 1 （P=0.056）, 6 （P=0.229） and 12 months of follow-up （P=0.367）. In the univariate analysis, severe compensatory sweating was inversely associated with patient satisfaction at 1, 6 and 12 months of follow-up （P=0.000, 0.000 and 0.000）. Family history was associated with patient satisfaction at 1 month of follow-up （P=0.019）, but not at 6 （P=0.094） or 12 months of follow-up （P=--0.068）. Age, gender, medical history, body mass index and different levels of sympathectomy were not related to patient satisfaction at 1, 6 or 12 months of follow-up （P〉 0.05）. Conclusions Lowering or restricting the level of sympathectomy can not increase the degree of patient satisfaction. There are no definite predictive factors for severe CS. Severe CS is the only definite factor that influences patient satisfaction.
出处
《中华腔镜外科杂志（电子版）》
2013年第3期19-22,共4页
Chinese Journal of Laparoscopic Surgery(Electronic Edition)
基金
中山大学"958"基金项目
