Thermal Ergonomics Laboratory, School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ontario, Canada.
Am J Physiol Regul Integr Comp Physiol. 2012 Feb 1;302(3):R352-6. doi: 10.1152/ajpregu.00419.2011. Epub 2011 Nov 23.
A side-effect of endoscopic thoracic sympathectomy (ETS) is compensatory hyperhidrosis (CH), characterized by excessive sweating from skin areas with intact sudomotor function. The physiological mechanism of CH is unknown, but may represent an augmented local sweat rate from skin areas with uninterrupted sympathetic innervation based on evaporative heat balance requirements. For a given combination of activity and climate, the same absolute amount of evaporation (if any) is needed to balance the rate of metabolic heat production both pre- and post-ETS. However, the rate of local sweating per unit of skin surface area with intact sudomotor activity must be greater post-ETS as evaporation must be derived from a smaller skin surface area. Under conditions with high evaporative requirements, greater degradations in sweating efficiency associated with an increased dripping of sweat should also occur post-ETS, further pronouncing the sweat rate required for heat balance. In conclusion, in addition to the potential role of psychological stimuli for increased sudomotor activity, the existence of CH post-ETS can be described by the interplay between fundamental thermoregulatory physiology and altered heat balance biophysics and does not require a postoperative alteration in physiological control.
胸腔镜胸交感神经切除术 (ETS) 的一种副作用是代偿性多汗症 (CH)，其特征是具有完整的自主神经功能的皮肤区域过度出汗。CH 的生理机制尚不清楚，但可能代表基于蒸发散热平衡要求，具有不间断交感神经支配的皮肤区域的局部出汗率增加。对于给定的活动和气候组合，在 ETS 之前和之后，需要相同的蒸发绝对量（如果有的话）来平衡代谢产热的速率。然而，由于蒸发必须来自较小的皮肤表面积，因此具有完整自主神经活动的单位皮肤表面积的局部出汗率在 ETS 后必须更大。在蒸发要求高的情况下，与出汗效率降低相关的出汗滴落增加也应该在 ETS 后发生，这进一步说明了为了达到热平衡所需的出汗率。总之，除了心理刺激对增加的自主神经活动的潜在作用外，ETS 后 CH 的存在可以通过基本体温调节生理学和改变的热平衡生物物理学之间的相互作用来描述，并且不需要术后对生理控制进行改变。
