Department of Cardiothoracic Surgery, Second Affiliated Hospital, Soochow University, Suzhou, Jiangsu 215004, China.
Chin Med J (Engl). 2011 Nov;124(21):3495-8.
Video-assisted thoracic sympathetic block is an effective, safe, and minimally invasive method for treatment of primary hyperhidrosis. The purpose of this study was to decide which one of using electrocautery hook and titanium clip is the appropriate procedure for primary palmar hyperhidrosis by assessing the compensatory sweating (CS) and quality of life (QOL) of patients after sympathetic block.
Between October 2007 to August 2010, 120 patients with primary palmar hyperhidrosis were randomly divided into two groups, electrocautery hook group (60 patients) and titanium clip group (60 patients). All patients were treated by sympathetic block at T4 level. The CS was graded based on severity and location; the QOL was classified to 5 different levels based upon the summed total scores (range from 20 to 100) before and after surgery. The variables were compared.
The postoperative follow-up period was 2 months. All patients were cured. Three patients in electrocautery hook group and 1 patient in titanium clip group had a unilateral pneumothorax on chest X-ray, but none of them was necessary to have chest drainage. Neither perioperative mortality nor serious complications such as cardiac arrhythmia or arrest were observed during the operation. No bradycardia or Horner's syndrome occured. CS was not more common in patients in titanium clip group than in those in electrocautery hook group (P = 0.001). Moderate and severe CS was few in all patients, and there was no significant difference between two groups (P = 0.193). Most of the patients feel a notable improvement of the the QOL; nevertheless, there was no significant difference between the groups (P = 0.588).
Both electrocautery hook and titanium clip used for sympathetic block at the T4 level are effective, safe, and minimally invasive for palmar hyperhidrosis. Because of the lower severity of CS and the similar improvements in the QOL after operation, we prefer to use of titanium clip for treating palmar hyperhidrosis.
视频辅助胸腔交感神经阻滞是治疗原发性多汗症的一种有效、安全且微创的方法。本研究旨在通过评估交感神经阻滞治疗原发性手掌多汗症患者的代偿性出汗（CS）和生活质量（QOL），来确定使用电钩和钛夹的哪一种方法更适合治疗原发性手掌多汗症。
2007 年 10 月至 2010 年 8 月，120 例原发性手掌多汗症患者随机分为电钩组（60 例）和钛夹组（60 例）。所有患者均在 T4 水平行交感神经阻滞治疗。根据严重程度和部位对 CS 进行分级；根据手术前后总分（20 至 100 分）将 QOL 分为 5 个不同等级。比较变量。
术后随访 2 个月。所有患者均治愈。电钩组 3 例和钛夹组 1 例患者胸片显示单侧气胸，但均无需胸腔引流。术中无围手术期死亡或心律失常或骤停等严重并发症。无心动过缓或霍纳综合征。钛夹组患者的 CS 发生率并不高于电钩组（P = 0.001）。两组患者中均为中度和重度 CS 少见，且两组间无显著差异（P = 0.193）。大多数患者的 QOL 显著改善；但两组间无显著差异（P = 0.588）。
T4 水平行交感神经阻滞时，电钩和钛夹均有效、安全且微创，可用于治疗手掌多汗症。由于 CS 严重程度较低，术后 QOL 改善相似，我们更倾向于使用钛夹治疗手掌多汗症。
