[T3交感神经切除术与T4交感神经切除术治疗原发性手掌多汗症的比较]

[A comparison of T3 sympathectomy versus T4 sympathectomy in the treatment of primary palmer hyperhidrosis].

作者信息

Liu Yan-guo, Yang Jie, Wang Jun, Liu Jun, Li Jian-feng, Jiang Guan-chao, Huang Yu-qing, Yang Fan, Zhao Hui

机构信息

Department of Thoracic Surgery, Center of Thoracic Mini-invasive Surgery, People's Hospital, Peking University, Beijing 100044, China.

出版信息

Zhonghua Yi Xue Za Zhi. 2006 Sep 5;86(33):2318-20.

PMID:17156625

Abstract

OBJECTIVE

To evaluate the effect and side effect of T(3) versus T(4) sympathectomy in the surgical management of primary palmar hyperhidrosis through prospective multi-center randomized controlled trial.

METHODS

From Sep 2004 to Feb 2006, 106 consecutive patients (49 males and 54 females) with primary palmar hyperhidrosis were enrolled in the study and randomly assigned into T(3) or T(4) level sympathectomy groups. 66 patients received T(3) sympathetic chain transection and 37 patients received T(4) sympathetic chain transection. The two groups were comparable in all other parameters.

RESULTS

All procedures were carried out successfully without severe morbidity or mortality. After a mean follow-up period of 8.6 months, both groups remained satisfactory in palmar sweating control. The T(4) group had more moisture hands compared with the T(3) branch (54.1% vs 15.2%, P < 0.01), but this didn't compromise the patients' satisfactory. The patients in T(4) group showed significantly less dry hand problems than the patients in the T(3) group (5.4% vs. 25.8%, P < 0.05), and so did compensatory sweating (21.6% vs. 45.6%, P < 0.05).

CONCLUSION

The procedure of T(3) or T(4) sympathectomy, both transecting the sympathetic chain in one single position in relatively lower segment, are comparatively effective in the treatment of primary palmar hyperhidrosis, but T(4) sympathectomy shows less side effect.

摘要

目的

通过前瞻性多中心随机对照试验，评估T（3）与T（4）交感神经切除术在原发性手掌多汗症手术治疗中的效果及副作用。

方法

2004年9月至2006年2月，106例连续的原发性手掌多汗症患者（49例男性和54例女性）纳入本研究，并随机分为T（3）或T（4）水平交感神经切除术组。66例患者接受T（3）交感神经链切断术，37例患者接受T（4）交感神经链切断术。两组在所有其他参数方面具有可比性。

结果

所有手术均成功完成，无严重并发症或死亡。平均随访8.6个月后，两组在手掌出汗控制方面均保持良好。与T（3）组相比，T（4）组手部潮湿情况更多（54.1%对15.2%，P<0.01），但这并未影响患者的满意度。T（4）组患者手部干燥问题明显少于T（3）组（5.4%对25.8%，P<0.05），代偿性出汗情况也是如此（21.6%对45.6%，P<0.05）。