化学性交感神经切除术治疗雷诺综合征97例经验

[Experience in treatment of Raynaud's syndrome by chemical sympathectomy: 97 cases].

作者信息

Han Jin Tao, Zhao Jun, Peng Yong Guang

机构信息

Department of Vascular Surgery, Peking University Third Hospital, Beijing, China.

出版信息

Beijing Da Xue Xue Bao Yi Xue Ban. 2008 Jun 18;40(3):310-3.

PMID:18560461

Abstract

OBJECTIVE

To summarize the curative effect in treatment of Raynaud's syndrome with chemical thoracic sympathectomy (CTS) guided by X-ray since 2001.

METHODS

From March 2001 to August 2007, 97 patients with Raynaud's syndrome (186 limbs) were treated by CTS. Guided by X-ray, a needle was punctured through the back skin to the second thoracic sympathetic ganglion beside the thoracic vertebrae and 2 mL of 5% (v/v) phenol was injected.

RESULTS

The first CTS treatment produced a good effect on 146 limbs with an effective rate of 78.5% (146/186). The same treatment was performed on the limbs with no effect 1-2 days after the first treatment and produced good effect on 13 limbs with an effective rate of 32.5% (13/40). The total effective rate of the patients who were hospitalized for the first time was 85.5% (159/186). Of the 97 patients, 78 patients (80.4%) were followed up for 47 months on an average with an effective rate of 69.5%. And the rate of complications was 11.4% for pheumothorax, and 3.9% for hydrothorax. Hyperalgesia on axillary region and anterior chest wall; Horner syndrome and sinus bradycardia were rare.

CONCLUSION

CTS is minimally invasive and effective in treatment of Raynaud's syndrome.

摘要

目的

总结2001年以来X线引导下化学性胸交感神经切除术（CTS）治疗雷诺综合征的疗效。

方法

2001年3月至2007年8月，97例雷诺综合征患者（186条肢体）接受CTS治疗。在X线引导下，经背部皮肤穿刺针至胸椎旁第二胸交感神经节，注入2ml 5%（v/v）苯酚。

结果

首次CTS治疗146条肢体效果良好，有效率为78.5%（146/186）。首次治疗后1-2天对无效肢体进行同样治疗，13条肢体效果良好，有效率为32.5%（13/40）。首次住院患者总有效率为85.5%（159/186）。97例患者中，78例（80.4%）平均随访47个月，有效率为69.5%。气胸并发症发生率为11.4%，胸腔积液并发症发生率为3.9%。腋窝区和前胸壁痛觉过敏；霍纳综合征和窦性心动过缓少见。