Sano T, Fukushige T, Miyagawa Y, Yamada S, Kano T
Department of Anesthesiology, Kurume University School of Medicine.
Masui. 1999 May;48(5):481-6.
We have investigated whether laser-Doppler (L-D) skin blood flowmetry on the finger could be useful for an intraoperative assessment of the efficacy of endoscopic thoracic sympathectomy (ETS) under general anesthesia. Subjects were 5 young adults receiving ETS for palmar hyperhidrosis. ETS was performed with the patients in the semi-sitting position under one lung ventilation. A pair of LDF probes were placed on the palmar side of the both second fingers. Palmar hyperhidrosis disappeared after ETS in all cases, but compensatory hyperhidrosis developed in the back of the body and the thigh. After completion of ETS on one side, the L-D skin blood flow increased to 267.6 +/- 211.1% on the side of ETS, and it increased in 2 other cases and decreased on the contrary in 3 cases on the other side. After ETS on both sides the L-D skin blood flow increased to 265.0 +/- 185.9% on the side of initial ETS and to 211.4 +/- 172.8% on the side of subsequent ETS. The initial EST induced reflex vasoconstriction on the finger of both sides and also on the toe. Spontaneous fluctuation and reflex vasoconstriction of the skin blood flow were still observed, although the periodicity of spontaneous fluctuation between the right and the left finger was lost in some of the cases. An increase in L-D skin blood flow on the side of ongoing ETS is useful for intraoperative assessment of ETS.
我们研究了手指激光多普勒（L-D）皮肤血流测量法是否有助于在全身麻醉下对内镜胸交感神经切除术（ETS）的疗效进行术中评估。受试者为5名因手掌多汗症接受ETS的年轻成年人。ETS在患者半卧位单肺通气下进行。将一对LDF探头置于双侧第二指的掌侧。所有病例中ETS后手掌多汗症消失，但身体背部和大腿出现代偿性多汗症。一侧ETS完成后，ETS侧的L-D皮肤血流增加至267.6±211.1%，另一侧2例增加，3例减少。双侧ETS后，初始ETS侧的L-D皮肤血流增加至265.0±185.9%，后续ETS侧增加至211.4±172.8%。初始ETS引起双侧手指以及脚趾的反射性血管收缩。尽管部分病例左右手指间自发波动的周期性消失，但仍观察到皮肤血流的自发波动和反射性血管收缩。正在进行ETS一侧的L-D皮肤血流增加有助于ETS的术中评估。
