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胸腔镜下交感神经切断术与交感神经切除术治疗原发性多汗症的比较

Thoracoscopic Sympathicotomy vs Sympathectomy in Primary Hyperhidrosis.

作者信息

Mohebbi Hassan Ali, Mehrvarz Shaban, Manoochehry Shahram

机构信息

Trauma Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran ; Department of General Surgery, Faculty of Medicine, Baqiyatallah University of Medical Sciences, Tehran, IR Iran.

Trauma Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran.

出版信息

Trauma Mon. 2012 Summer;17(2):291-5. doi: 10.5812/traumamon.6335. Epub 2012 Jul 31.

Abstract

BACKGROUND

Primary hyperhidrosis (P.H.H.) is characterized by excessive sweating in certain parts of body. It's estimated prevalence is 0%-6.1% in different populations. In Asian population its prevalence is around 3%. In 57% of cases, there is a positive family history.

OBJECTIVES

To evaluate and compare the early and late satisfaction, outcomes and complications of thoracoscopic sympathectomy and sympathicotomy in the treatment of primary hyperhidrosis.

MATERIALS AND METHODS

From April 2007 to January 2011, we prospectively treated 60 primary hyperhidrosis patients via thoracoscopic surgery. The first 30 patients underwent sympathectomy and the next 30 patients underwent sympathicotomy. We evaluated early and late satisfactions, outcomes and complications on the first visit (5-8days) following surgery and 12 months after surgery, for all patients.

RESULTS

The mean operative time was 66.3 minutes in sympathicotomy group and 110.8 minutes in sympathectomy group (P < 0.001). There were no significant differences between the two groups in overall early and late satisfaction, gustatory sweating, pompholyx and post-operative pain. There was comparatively less early and late compensatory sweating (C.S.), and other adverse influences of C.S. in the sympathicotomy group.

CONCLUSIONS

Because of shorter operative time, less C.S. and less adverse influence of C.S., sympathicotomy seems a better treatment for primary hyperhidrosis, compared with sympathectomy.

摘要

背景

原发性多汗症(P.H.H.)的特征是身体某些部位出汗过多。在不同人群中,其估计患病率为0% - 6.1%。在亚洲人群中,其患病率约为3%。57%的病例有阳性家族史。

目的

评估和比较胸腔镜交感神经切除术和交感神经切断术治疗原发性多汗症的早期和晚期满意度、疗效及并发症。

材料与方法

2007年4月至2011年1月,我们对60例原发性多汗症患者进行了胸腔镜手术的前瞻性治疗。前30例患者接受交感神经切除术,后30例患者接受交感神经切断术。我们对所有患者在术后首次就诊(5 - 8天)和术后12个月时评估早期和晚期满意度、疗效及并发症。

结果

交感神经切断术组的平均手术时间为66.3分钟,交感神经切除术组为110.8分钟(P < 0.001)。两组在总体早期和晚期满意度、味觉性出汗、汗疱疹和术后疼痛方面无显著差异。交感神经切断术组的早期和晚期代偿性出汗(C.S.)相对较少,且C.S.的其他不良影响也较少。

结论

与交感神经切除术相比,交感神经切断术手术时间更短,C.S.更少且C.S.的不良影响更小,似乎是治疗原发性多汗症的更好方法。

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