Koskinen L-O D, Blomstedt P
Department of Pharmacology and Clinical Neuroscience, Division of Neurosurgery, University of Umeå, Sweden.
Acta Neurol Scand. 2008 Dec;118(6):402-6. doi: 10.1111/j.1600-0404.2008.01046.x. Epub 2008 Jun 5.
To study the sympathetically mediated effects of transthoracic endoscopic sympathicotomy (TES) in the treatment of severe primary palmar hyperhidrosis.
The effects of TES, on sympathetic ganglia at the thoracic level of 2-3, finger blood flow, temperature, and on heat and cold provocation were investigated. Middle cerebral artery (MCA) blood flow velocities were studied by transcranial Doppler.
The finger blood flow increased by about 700% after TES and finger temperature by 7.0 +/- 0.5 degrees C. Several autonomic reflexes were dramatically affected. A finger pulp-shrinking test showed a major decrease after surgery. MCA mean blood flow velocities were not affected by TES.
Besides the high success rate of good clinical effect of TES on palmar hyperhidrosis, major effects on local blood flow and temperature are elicited by TES. Complex autonomic reflexes are also affected. The patient should be completely informed before surgery of the side effects elicited by TES.
研究经胸内镜胸交感神经切断术（TES）治疗重度原发性手掌多汗症时交感神经介导的效应。
研究TES对2 - 3胸段交感神经节、手指血流、温度以及热冷刺激的影响。采用经颅多普勒研究大脑中动脉（MCA）血流速度。
TES后手指血流增加约700%，手指温度升高7.0±0.5℃。多个自主神经反射受到显著影响。术后指腹收缩试验显示明显下降。TES未影响MCA平均血流速度。
除TES治疗手掌多汗症临床效果成功率高外，TES还对手部局部血流和温度产生主要影响。复杂的自主神经反射也受到影响。术前应向患者充分告知TES引发的副作用。
