Moya J, Ramos R, Morera R, Villalonga R, Perna V, Macia I, Ferrer G
Servicio de Cirugía Torácica, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, España.
Arch Bronconeumol. 2006 May;42(5):230-4. doi: 10.1016/s1579-2129(06)60451-5.
Thoracic sympatholysis and sympathectomy are the current standard treatments for primary hyperhidrosis. In this study, we evaluated the incidence of peri- and postoperative complications associated with these procedures.
From 1996 to 2004, 520 consecutive patients (364 women), with a mean age of 26.8 years, were treated for primary hyperhidrosis at our hospital. The procedure was bilateral in all but 24 cases. The 484 patients in the sympatholysis group underwent a single intervention while the 36 patients in the sympathectomy group underwent 2 separate interventions.
No deaths occurred. Anhidrosis of the target area was achieved in 97.6% of patients while 2.2% experienced hypohidrosis. In 0.2% of the cases, the procedure was initially unsuccessful and a second intervention was required. The mean duration of hospital stay was 72 hours for patients in the sympathectomy group and 17 hours for the sympatholysis group. Serious intraoperative complications requiring conversion to thoracotomy were recorded in 0.2% of patients. Postoperative complications--of which pneumothorax was the most common--occurred in 5.2% of the cases (in 22.5% of the sympathectomy group and 3.55% of the sympatholysis group). Compensatory hyperhidrosis occurred in 48.4% of the patients, excessive dryness of the hands and palpebral ptosis in 0.38%, and gustatory sweating in 0.9%. The degree of patient satisfaction was quite high (88.5%) and only 2.3% were very unsatisfied.
Given the results obtained, we can conclude that both sympatholysis and sympathectomy are appropriate treatments for hyperhidrosis. Nonetheless, because sympatholysis is both easier to perform and less aggressive, we consider it the treatment of choice for primary hyperhidrosis.
胸交感神经阻滞术和交感神经切除术是目前原发性多汗症的标准治疗方法。在本研究中，我们评估了与这些手术相关的围手术期和术后并发症的发生率。
1996年至2004年，我院连续治疗了520例原发性多汗症患者（364例女性），平均年龄26.8岁。除24例患者外，其余均接受双侧手术。交感神经阻滞术组的484例患者接受了单次干预，而交感神经切除术组的36例患者接受了2次单独干预。
无死亡病例。97.6%的患者实现了目标区域无汗，2.2%的患者出现少汗。0.2%的病例手术最初未成功，需要进行二次干预。交感神经切除术组患者的平均住院时间为72小时，交感神经阻滞术组为17小时。0.2%的患者记录有需要转为开胸手术的严重术中并发症。术后并发症——其中气胸最为常见——发生率为5.2%（交感神经切除术组为22.5%，交感神经阻滞术组为3.55%）。48.4%的患者出现代偿性多汗，0.38%的患者出现手部过度干燥和上睑下垂，0.9%的患者出现味觉性出汗。患者满意度相当高（88.5%），只有2.3%的患者非常不满意。
根据所获得的结果，我们可以得出结论，交感神经阻滞术和交感神经切除术都是多汗症的合适治疗方法。尽管如此，由于交感神经阻滞术操作更简便且创伤性更小，我们认为它是原发性多汗症的首选治疗方法。
