摘要
目的 :本文评价了胸腔镜交感神经干切断术治疗手汗症的安全性和有效性。方法 :自 1996年 6月～ 2 0 0 0年 12月 ,38例多汗症患者在全麻双腔插管下行双侧胸腔镜胸交感神经切除术。男 18例 ,女 2 0例 ,平均年龄2 4 .6岁 (14～ 4 6岁 )。单纯手汗症者采用电凝毁损胸2 交感神经节 ;手汗症合并腋窝多汗症 ,则切除胸2～ 4交感神经节。术毕排出胸腔残余气体 ,不置胸腔引流管。结果 :术后多汗症状全部消失。麻醉清醒后 ,病人双手干燥而温暖。全组无手术死亡。平均双侧手术时间 36min(12～ 90min) ,平均住院时间 5 .8d。平均随访时间33.4月 (6～ 5 4月 )。 15例 (39.5 % )病人出现上肢以外的代偿性多汗 ,但基本可以忍受 ,不影响生活 ,无需进一步治疗。无复发病例 ,病人满意。结论 :胸腔镜胸交感神经切除术是手汗症和腋窝多汗症的最有效的微创治疗手段。
Objective:The aim of this study was to evaluate the efficacy and safety of thoracoscopic sympathectomies for primary and axillary hyperhidrosis.Methods:From June 1996 to December 2000, 38 thoracoscopic sympathectomies(TS) were performed. There were 18 males and 20 females with a mean age of 24.6 years (rang,14 to 46 years). The procedures were performed with the patients under general anesthesia using a double-lumen endotracheal tube. In palmar hyperhidrosis the second thoracic sympathetic ganglia were destroyed by electrocautery. In axillary hyperhidrosis the second to fourth ganglion were cut off. Results: The symptoms disappeared completely in all patients immediately after the operation. Their hands were dry and warm when they waked up from anaesthesia. There was no surgical mortality. Median operation time for a bilateral procedure is 36 min. (range, 12～90min). The average hospital stay was 5.8 days. The mean follow-up time was 33.4 months (range, 6～54months). Compensatory hyperhidrosis was found in 39.5% (15/38) of patients, but the symptoms were not serve enough to interfere with lifestyle, and were not required further treatment. In all 38 patients had a satisfactory result, without recurrence of palmar or axillary hyperhidrosis.Conclusion: Thoracoscopic sympathectomy is the most effective and minimally invasive treatment for palmar and axillary hyperhidrosis.
出处
《中国内镜杂志》
CSCD
2002年第8期8-10,共3页
China Journal of Endoscopy
