青少年多汗症患者胸腔镜交感神经切断术治疗结果的对比分析。
Comparative analysis of the results of videothoracoscopic sympathectomy in the treatment of hyperhidrosis in adolescent patients.
机构信息
Department of Vascular and Endovascular Surgery, Hospital Israelita Albert Einstein.
Department of Vascular and Endovascular Surgery, Hospital Israelita Albert Einstein.
出版信息
J Pediatr Surg. 2020 Mar;55(3):418-424. doi: 10.1016/j.jpedsurg.2019.11.004. Epub 2020 Jan 23.
OBJECTIVE
Several factors that could influence the efficacy and satisfaction of patients after bilateral thoracic sympathectomy (VATS) in the treatment of hyperhidrosis (HH) have been studied, but no studies in the literature have specifically analyzed the effectiveness of treatment and variations in the quality of life of adolescents patients compared to those of adult patients (18-40 years).
METHODS
We retrospectively analyzed 2431 hyperhidrosis patients who underwent bilateral VATS and divided the patients into the following groups: adolescents (472 patients) and adult group (1760 patients). Variables included quality of life prior to surgery, improvement in quality of life after surgery, clinical improvement in sweating, presence of severe compensatory hyperhidrosis and general satisfaction at one month after surgery.
RESULTS
We observed that all surgical patients presented with poor or very poor quality of life before surgery, with similar proportions in both groups. In the postoperative period, we observed improvement in quality of life in more than 90% of the patients, with no significant difference noted between the two groups of patients. We observed that all patients undergoing surgery presented poor or very poor quality of life before surgery; however, the two groups were statistically different. The quality of life of the ADOLESCENT group before surgery was statistically worse than that of the ADULT group. More than 90% of the patients in this series had great clinical improvement in the main hyperhidrosis site, with no significant difference between the two groups. Severe compensatory hyperhidrosis occurred in 23.8% of the patients in this series, with no significant difference between the two groups.
CONCLUSIONS
Adolescent patients benefit just as much as adult patients from VATS performed to treat primary hyperhidrosis, presenting excellent, significant surgical results.
TYPE OF STUDY
Clinical research.
LEVELS OF EVIDENCE
Level III.
目的
已经研究了许多可能影响双侧胸腔镜交感神经切断术（VATS）治疗多汗症（HH）后患者疗效和满意度的因素，但文献中尚无研究专门分析青少年患者与成年患者（18-40 岁）相比，治疗效果和生活质量变化。
方法
我们回顾性分析了 2431 例接受双侧 VATS 的多汗症患者，并将患者分为以下两组：青少年组（472 例）和成年组（1760 例）。变量包括术前生活质量、术后生活质量改善、出汗的临床改善、严重代偿性多汗的存在以及术后 1 个月的总体满意度。
结果
我们观察到所有手术患者术前生活质量均较差或极差，两组患者的比例相似。在术后期间，我们观察到超过 90%的患者生活质量得到改善，但两组患者之间没有显著差异。我们观察到所有手术患者术前生活质量均较差或极差；然而，两组患者在统计学上存在差异。青少年组术前生活质量明显差于成年组。本系列中超过 90%的患者主要多汗部位有很好的临床改善，两组之间无显著差异。本系列中有 23.8%的患者发生严重代偿性多汗，两组之间无显著差异。
结论
青少年患者从 VATS 治疗原发性多汗症中获益与成年患者一样多，手术效果极佳，显著。
研究类型
临床研究。
证据水平
III 级。
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