Saetre Torunn, Flørenes Tor
Oslo karkirurgiske senter, Aker universitetssykehus, 0514 Oslo.
Tidsskr Nor Laegeforen. 2005 Oct 20;125(20):2795-7.
Severe palmar hyperhidrosis and facial blushing are conditions connected with considerable psychosocial burden. Conservative treatment is often of limited value. Several reports have demonstrated high success rates in thoracoscopic sympathectomy. Treatment results from Norwegian centres have not previously been published.
The long term effects of thoracoscopic sympathectomy performed between 1998 and 2002 at Aker University Hospital were evaluated by questionnaire, using VAS scores (visual analogue scales) obtained from 72 out of 76 operated patients.
In palmar hyperhidrosis, a reduction in VAS score above 3 was reported in 27 of 28 patients (from mean 9.5 +/- 0.2 to 0.8 + 0.4). In facial blushing, 39 of 44 patients reported a reduction in VAS score above 3 (from mean 8.9 +/- 0.3 to 2.5 +/- 0.4). The overall satisfaction rate was 90 %. A majority of patients (86 %) experienced variable but lasting compensatory general hyperhidrosis. However, only a few patients found this condition disabling to the extent that it caused regret (3 patients) or dissatisfaction (4 patients).
Thoracoscopic sympathectomy markedly reduces palmar hyperhidrosis and facial blushing, but the indication should be strong and the information thorough because of compensatory hyperhidrosis.
严重的手掌多汗症和面部潮红会带来相当大的心理社会负担。保守治疗往往效果有限。多项报告显示胸腔镜交感神经切除术成功率很高。此前挪威各中心的治疗结果尚未公布。
通过问卷调查对1998年至2002年在阿克大学医院进行的胸腔镜交感神经切除术的长期效果进行评估，使用从76例手术患者中的72例获得的视觉模拟量表（VAS）评分。
在手掌多汗症患者中，28例患者中有27例报告VAS评分降低超过3分（从平均9.5±0.2降至0.8±0.4）。在面部潮红患者中，44例患者中有39例报告VAS评分降低超过3分（从平均8.9±0.3降至2.5±0.4）。总体满意率为90%。大多数患者（86%）经历了程度不一但持续存在的代偿性全身多汗症。然而，只有少数患者认为这种情况严重到引起后悔（3例）或不满（4例）。
胸腔镜交感神经切除术可显著减轻手掌多汗症和面部潮红，但由于存在代偿性多汗症，手术指征应严格，且信息应充分告知。
