Drott Christer, Claes Göran, Rex Lars
Department of Surgery, Borås Hospital, Sweden.
J Cosmet Dermatol. 2002 Oct;1(3):115-9. doi: 10.1046/j.1473-2165.2002.00047.x.
Severe facial blushing may have a strong negative impact on the quality of life and is one of the cardinal symptoms of social phobia. If traditional therapeutic options such as psychotherapy and pharmacological treatment fail, interruption of the sympathetic innervation to the face offers good results, however long-term results may not be good.
To investigate whether endoscopic thoracic sympathecotomy (ETS) remains an effective treatment of facial blushing more than one year's follow up.
1314 consecutive patients with severe facial blushing were treated with bilateral ETS. The results were evaluated by questionnaire and symptoms assessed with visual analogue scales (0-10).
The questionnaire was completed by 831 patients (63%) a mean of 29 months (+/- 11 days) after surgery. Facial blushing was reduced from 8.8 +/- 0.05 to 2.5 +/- 0.09, P < 0.0001 by the operation. The quality of life was substantially improved. The main side-effect was redistribution of sweating from the upper to the lower part of the body (compensatory sweating). Increased sweating of the trunk occurred in 83% of the responses. Overall, 85% of the respondents were satisfied with the result and 15% were to some degree not satisfied.
As this is an open study and 37% of patients did not respond to the questionnaire, the results must be viewed with caution. ETS, however, appears to be an effective, safe and lasting surgical method for the treatment of severe facial blushing. Side-effects, especially compensatory sweating on the trunk and legs are common, and may be severe but only rarely result in the patient regretting the operation.
严重面部潮红可能对生活质量产生强烈负面影响，是社交恐惧症的主要症状之一。如果心理治疗和药物治疗等传统治疗方法无效，对面部交感神经支配的阻断可取得良好效果，但长期效果可能不佳。
研究内镜胸交感神经切断术（ETS）在随访一年以上时是否仍是治疗面部潮红的有效方法。
1314例连续性严重面部潮红患者接受双侧ETS治疗。通过问卷调查评估结果，并用视觉模拟量表（0 - 10）评估症状。
831例患者（63%）在术后平均29个月（±11天）完成问卷调查。手术使面部潮红从8.8±0.05降至2.5±0.09，P < 0.0001。生活质量得到显著改善。主要副作用是出汗从身体上部重新分布到下部（代偿性出汗）。83%的回复者出现躯干出汗增加。总体而言，85%的受访者对结果满意，15%在某种程度上不满意。
由于这是一项开放性研究且37%的患者未回复问卷，结果必须谨慎看待。然而，ETS似乎是治疗严重面部潮红的一种有效、安全且持久的手术方法。副作用，尤其是躯干和腿部的代偿性出汗很常见，可能很严重，但很少导致患者后悔接受手术。
