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[电视辅助胸腔镜交感神经切除术治疗588例手掌多汗症]

[Video-assisted thoracoscopic sympathectomy for the treatment of palmar hyperhidrosis in 588 cases].

作者信息

Tu Yuan-rong, Li Xu, Lin Min, Lai Fan-cai, Chen Jian-feng

机构信息

Department of Thoracic Surgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, China.

出版信息

Zhonghua Wai Ke Za Zhi. 2007 Nov 15;45(22):1527-9.

Abstract

OBJECTIVE

To evaluate the efficacy of video-assisted thoracoscopic sympathectomy in the treatment of palmar hyperhidrosis and introduce the clinical experience in the prevention of complications.

METHODS

The clinic data of 588 cases of palmar hyperhidrosis who underwent bilateral sympathectomy from January 2003 and March 2007 was analyzed retrospectively. The curative results were compared between the T(2) levels denervation group (group A) and the T(2) levels remained denervation group (group B).

RESULTS

All operations were successfully performed under thoracoscope without severe morbidity and mortality. The curative rate of palmar hyperhidrosis was 99.8%. Accompanied axillary sweating and plantar sweating were improved in 84.0% and 71.0% patients respectively. All the patients were evaluated by a follow-up for 1 to 48 months with an average time of (20.3 +/- 2.3) months on the aspects of curative effect and occurrence of compensatory sweating. During one week after surgery, the transient postoperative hand sweating recurred in 10 cases and then disappeared within 1 to 3 days. Two cases experienced gustatory hyperhidrosis. One case experienced hand sweating at 8 th month postoperative. Side-effect of compensatory sweating were observed in 28.0 percent of group A and 13.4 percent of group B (P < 0.01).

CONCLUSIONS

Video-assisted thoracoscopic sympathectomy is an effective, safe and minimally invasive method for the treatment of hyperhidrosis. The method of T(2) levels remained denervation appears associated with less compensatory sweating.

摘要

目的

评估电视胸腔镜交感神经切除术治疗手掌多汗症的疗效,并介绍预防并发症的临床经验。

方法

回顾性分析2003年1月至2007年3月期间588例行双侧交感神经切除术的手掌多汗症患者的临床资料。比较T₂水平去神经组(A组)和T₂水平保留去神经组(B组)的治疗效果。

结果

所有手术均在胸腔镜下成功完成,无严重并发症及死亡。手掌多汗症的治愈率为99.8%。分别有84.0%和71.0%的患者伴随的腋窝多汗和足底多汗得到改善。所有患者随访1至48个月,平均随访时间为(20.3±2.3)个月,观察疗效及代偿性出汗的发生情况。术后1周内,10例患者出现短暂性手部出汗复发,随后在1至3天内消失。2例患者出现味觉性多汗症。1例患者术后8个月出现手部出汗。A组代偿性出汗的副作用发生率为28.0%,B组为13.4%(P<0.01)。

结论

电视胸腔镜交感神经切除术是治疗多汗症的一种有效、安全且微创的方法。T₂水平保留去神经的方法似乎与较少的代偿性出汗相关。

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