Kara Murat, Kose Selcuk, Cayirci Can Ertug, Koksal Ayhan
Department of Thoracic Surgery, Istanbul University School of Medicine, Istanbul, Turkey.
Department of Thoracic Surgery, Bakirkoy Research and Training Hospital, Istanbul, Turkey.
Indian J Thorac Cardiovasc Surg. 2019 Apr;35(2):190-195. doi: 10.1007/s12055-018-0769-1. Epub 2018 Dec 14.
Primary hyperhidrosis is a functionally and socially disabling condition resulting in social embarrassment and low quality of life. Thoracic sympathectomy is a definitive choice of treatment with favorable results. However, patients may face another embarrassing condition following surgery as compensatory hyperhidrosis which has no definitive treatment. The predictors of compensatory hyperhidrosis are controversial and remain unclear.
A total of 74 patients underwent a videothoracoscopic sympathectomy for primary hyperhidrosis. We statistically analyzed our patients with correlations and uni-multivariate logistic regression models to outline the possible predictors of compensatory hyperhidrosis.
A total of 45 (60.8%) patients had compensatory hyperhidrosis. The correlations showed that patients, with age greater than 21 years ( = 0.018), with body mass index (BMI) greater than 22 kg / m ( = 0.045), with isolated facial hyperhidrosis ( = 0.044), and with smoking status ( = 0.015), had significantly greater rates of compensatory hyperhidrosis. Similarly, the significant univariate predictors of compensatory hyperhidrosis were age > 21 ( = 0.020), BMI > 22 kg / m ( = 0.048), and the presence of smoking status ( = 0.015). Multivariate analysis revealed only smoking as a predictor within the threshold of significance ( = 0.078).
The clinical predictors of compensatory hyperhidrosis following a thoracic sympathectomy appear as older age, greater body mass index, and smoking.
原发性多汗症是一种在功能和社交方面造成障碍的疾病，会导致社交尴尬和生活质量低下。胸交感神经切除术是一种疗效良好的确定性治疗选择。然而，患者术后可能会面临另一种尴尬情况，即代偿性多汗症，目前尚无确切的治疗方法。代偿性多汗症的预测因素存在争议且尚不明确。
共有74例患者接受了电视胸腔镜交感神经切除术治疗原发性多汗症。我们运用相关性分析以及单变量和多变量逻辑回归模型对患者进行统计学分析，以确定代偿性多汗症的可能预测因素。
共有45例（60.8%）患者出现代偿性多汗症。相关性分析表明，年龄大于21岁（P = 0.018）、体重指数（BMI）大于22 kg/m²（P = 0.045）、单纯面部多汗症（P = 0.044）以及吸烟状况（P = 0.015）的患者，代偿性多汗症的发生率显著更高。同样，代偿性多汗症的显著单变量预测因素为年龄>21岁（P = 0.020）、BMI>22 kg/m²（P = 0.048）以及吸烟状况（P = 0.015）。多变量分析显示，仅吸烟在显著性阈值内为预测因素（P = 0.078）。
胸交感神经切除术后代偿性多汗症的临床预测因素似乎为年龄较大、体重指数较高和吸烟。
