仅T3交感神经切除术与T3-T4交感神经切除术治疗腋窝多汗症的疗效及代偿性出汗比较。
Comparison of only T3 and T3-T4 sympathectomy for axillary hyperhidrosis regarding treatment effect and compensatory sweating.
作者信息
Yuncu Gökhan, Turk Figen, Ozturk Gökhan, Atinkaya Cansel
机构信息
Department of Thoracic Surgery, Pamukkale University Faculty of Medicine, Denizli, Turkey.
出版信息
Interact Cardiovasc Thorac Surg. 2013 Aug;17(2):263-7. doi: 10.1093/icvts/ivt160. Epub 2013 May 3.
OBJECTIVES
Patients diagnosed with axillary hyperhidrosis can face psychosocial issues that can ultimately hinder their quality of life both privately and socially. The routine treatment for axillary hyperhidrosis is T3-T4 sympathectomy, but compensatory sweating is a serious side effect that is commonly seen with this approach. This study was designed to evaluate whether a T3 sympathectomy was effective for the treatment of axillary hyperhidrosis and whether this treatment led to less compensatory sweating than T3-T4 sympathectomies among our 60-patient population.
METHODS
One hundred and twenty endoscopic thoracic sympathectomies were performed on 60 patients who had axillary hyperhidrosis. The sympathectomies were accomplished by means of a single-lumen endotracheal tube and a single port. The axillary hyperhidrosis patients were randomly divided into two groups with 17 patients in Group 1 undergoing T3-T4 sympathectomies and 43 in Group 2 undergoing only T3 sympathectomies. We analysed the data associated with the resolution of axillary hyperhidrosis, the degree of patient satisfaction with the surgical outcome and the quality of life in parallel with compensatory sweating after the procedure as reported by the patient and confirmed by the examiner. Moreover, the results were compared statistically.
RESULTS
No statistically significant difference was observed between the groups based on age (P=0.56), gender (P=0.81), duration of the surgery (P=0.35) or postoperative satisfaction levels (P=0.45). However, the incidence and degree of compensatory sweating were lower in the T3 group than the T3-T4 group at the 1-year follow-up (P=0.008).
CONCLUSIONS
T3 sympathectomy was as effective as T3-T4 sympathectomy for the treatment of axillary hyperhidrosis based on the patients' reported postoperative satisfaction, and the T3 group demonstrated lower compensatory sweating at the 1-year follow-up.
目的
被诊断为腋窝多汗症的患者可能面临心理社会问题，这些问题最终会在个人生活和社交生活中阻碍他们的生活质量。腋窝多汗症的常规治疗方法是T3 - T4交感神经切除术，但代偿性出汗是这种治疗方法常见的严重副作用。本研究旨在评估T3交感神经切除术治疗腋窝多汗症是否有效，以及在我们的60名患者群体中，这种治疗方法导致的代偿性出汗是否比T3 - T4交感神经切除术更少。
方法
对60例腋窝多汗症患者进行了120次内镜胸交感神经切除术。交感神经切除术通过单腔气管插管和单孔完成。腋窝多汗症患者被随机分为两组，第1组17例患者接受T3 - T4交感神经切除术，第2组43例患者仅接受T3交感神经切除术。我们分析了与腋窝多汗症缓解相关的数据、患者对手术结果的满意度以及术后患者报告并经检查者确认的代偿性出汗情况下的生活质量。此外，对结果进行了统计学比较。
结果
两组在年龄（P = 0.56）、性别（P = 0.81）、手术时长（P = 0.35）或术后满意度水平（P = 0.45）方面未观察到统计学显著差异。然而，在1年随访时，T3组的代偿性出汗发生率和程度低于T3 - T4组（P = 0.008）。
结论
根据患者报告的术后满意度，T3交感神经切除术治疗腋窝多汗症与T3 - T4交感神经切除术效果相同，且T3组在1年随访时代偿性出汗较少。
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