原发性手掌多汗症交感神经切除术的最佳水平：T3 与 T4 的回顾性队列研究。
Optimal level of sympathectomy for primary palmar hyperhidrosis: T3 versus T4 in a retrospective cohort study.
机构信息
Department of General Surgery, Faculty of Medicine, Mansoura University Hospital, El Gomhoria Street, Mansoura, Egypt.
Department of General Surgery, Faculty of Medicine, Mansoura University Hospital, El Gomhoria Street, Mansoura, Egypt.
出版信息
Int J Surg. 2014;12(8):778-82. doi: 10.1016/j.ijsu.2014.05.039. Epub 2014 May 27.
BACKGROUND
To compare the results obtained with T3 versus T4 sympathectomy in treatment of primary palmar hyperhidrosis (PH).
METHODS
By retrospective review of medical records of patients with PH who underwent thoracoscopic sympathectomy from February, 2009 to September, 2012. The patients were categorized into two groups: T3 group underwent T3 sympathectomy and T4 group underwent T4 sympathectomy. Patients were evaluated according to the results of sweating, compensatory hyperhidrosis (CH), degree of satisfaction, complications and recurrence. Mean follow up was 19 ± 7 months.
RESULTS
A total of 274 consecutive patients with PH were included in this study. There were 169 females and 105 males, with mean age of 29 ± 11 years. 129 patients underwent T3 sympathectomy (T3 group). The T4 group included 145 patients who underwent T4 sympathectomy. 71.7% patients of T4 group did not complain of CH in comparison to 25.6% patients in group T3 (P = 0.001) and the incidence of mild to moderate CH was higher in the T3 group than T4 (64.4% vs. 26.9%; p = 0.001). T4 group showed a great significance in the (very satisfied category) in comparison to T3 group (P = 0.001). The incidence of over-dry hands was significantly lower in group T4 (0.7%, 1 out of 145) than in group T3 (8.5%, 11 out of 129). The recurrence rate was similar in the two groups (0.8% vs. 1.4%; P = 0.19).
CONCLUSION
Video-assisted T3 or T4 sympathectomy is a safe and effective procedure for treatment of palmar hyperhidrosis. T4 sympathectomy appears associated with less severe dryness and CH than T3 sympathectomy at long-term follow-up.
背景
比较 T3 与 T4 交感神经切断术治疗原发性手掌多汗症（PH）的结果。
方法
通过回顾 2009 年 2 月至 2012 年 9 月间接受胸腔镜交感神经切断术的 PH 患者的病历。患者分为两组：T3 组行 T3 交感神经切断术，T4 组行 T4 交感神经切断术。根据出汗、代偿性多汗（CH）、满意度、并发症和复发情况对患者进行评估。平均随访 19±7 个月。
结果
共有 274 例连续 PH 患者纳入本研究。其中女 169 例，男 105 例，平均年龄 29±11 岁。129 例患者行 T3 交感神经切断术（T3 组），T4 组 145 例患者行 T4 交感神经切断术。T4 组 71.7%的患者无 CH 抱怨，而 T3 组仅 25.6%（P=0.001），T3 组轻度至中度 CH 发生率高于 T4 组（64.4%比 26.9%；P=0.001）。T4 组在（非常满意类别）方面明显优于 T3 组（P=0.001）。T4 组手部过度干燥的发生率明显低于 T3 组（0.7%，1/145）（8.5%，11/129）。两组复发率相似（0.8%比 1.4%；P=0.19）。
结论
视频辅助 T3 或 T4 交感神经切断术是治疗手掌多汗症的安全有效方法。T4 交感神经切断术在长期随访中与 T3 交感神经切断术相比，手部干燥和 CH 程度较轻。
Zotero 插件