Panhofer P, Zacherl J, Jakesz R, Bischof G, Neumayer C
Department of General Surgery, University Clinic of Surgery, Medical University of Vienna, Austria.
Br J Surg. 2006 May;93(5):582-6. doi: 10.1002/bjs.5304.
The aim of the study was to assess two disease-specific quality of life (QoL) instruments after limited endoscopic thoracic sympathetic block (TS) at T4 for upper limb hyperhidrosis.
: Between 2001 and 2005, 112 patients underwent 223 TS procedures in a prospective study. Some 103 patients (92.0 per cent) had palmar, 87 (77.7 per cent) had axillary and 75 (67.0 per cent) had combined hyperhidrosis. QoL questionnaires devised by Keller et al. and Milanez de Campos et al. were employed before and after treatment. Mean(s.d.) follow-up was 21.9(10.1) months.
A total of 106 patients (94.6 per cent) were evaluated. All patients with palmar hyperhidrosis were completely or almost dry after surgery. Side-effects of compensatory sweating and gustatory sweating were observed in 17.0 and 28.3 per cent of patients respectively. QoL improved after TS in 100 per cent (Keller) and 97.3 per cent (Milanez de Campos) of patients illustrated by ameliorated scores of 78.7 and 67.8 per cent, respectively (both P < 0.001). Both questionnaires showed that compensatory sweating resulted in reduced postoperative QoL (P = 0.011, Keller; P = 0.032, Milanez de Campos).
Endoscopic sympathetic block at T4 leads to improved QoL. Both current questionnaires fulfilled validation criteria for disease-specific QoL instruments in upper limb hyperhidrosis.
本研究旨在评估在T4水平进行有限内镜胸交感神经阻滞（TS）治疗上肢多汗症后两种疾病特异性生活质量（QoL）评估工具的效果。
在2001年至2005年期间，112例患者参与了一项前瞻性研究，共接受了223次TS手术。约103例患者（92.0%）有手掌多汗症，87例（77.7%）有腋窝多汗症，75例（67.0%）有合并性多汗症。在治疗前后采用了Keller等人以及Milanez de Campos等人设计的QoL问卷。平均（标准差）随访时间为21.9（10.1）个月。
共评估了106例患者（94.6%）。所有手掌多汗症患者术后完全或几乎完全干爽。分别有17.0%和28.3%的患者观察到代偿性出汗和味觉性出汗等副作用。TS术后，100%（Keller问卷）和97.3%（Milanez de Campos问卷）的患者生活质量得到改善，得分分别提高了78.7%和67.8%（均P < 0.001）。两份问卷均显示代偿性出汗导致术后生活质量下降（Keller问卷P = 0.011；Milanez de Campos问卷P = 0.032）。
T4水平的内镜下交感神经阻滞可改善生活质量。目前这两份问卷均符合上肢多汗症疾病特异性QoL评估工具的验证标准。
