Yilmaz E N, Dur A H, Cuesta M A, Rauwerda J A
Department of Vascular Surgery, Free University Hospital, Amsterdam, The Netherlands.
Eur J Cardiothorac Surg. 1996;10(3):168-72. doi: 10.1016/s1010-7940(96)80292-2.
Thoracic sympathectomy is effective in the permanent cure of primary axillary and palmar hyperhidrosis and facial blushing, which can be so troublesome for patients that their social and professional relations can be affected. Between October 1988 and April 1994, a total of 50 thoracic sympathectomies (10 surgical and 40 endoscopic) were performed on 5 and 23 patients, respectively. The operations were performed unilaterally, followed by the contralateral intervention after a period of 6-8 weeks. The thoracic ganglia T2-T5 were resected for hyperhidrosis. If the patient suffered from blushing, the lower 1/3 of the stellate ganglion was also resected. Postoperatively, all the operated limbs were warm and dry. In the group of patients who were operated bilaterally, only one had persistent facial blushing. The efficacy for blushing in this series was therefore 93.3%. The late relapse rate of sympathetic activity was 14.3%. Compensatory sweating was seen in 67%, gustatory sweating in 37.5% and phantom sweating in 29% of the patients. None of them considered these side effects to be troublesome. Although there is no difference between transaxillary thoracic sympathectomy and the endoscopic intervention in terms of efficacy, the latter is associated with less postoperative pain, shorter hospital stay and a rapid recovery. The thoracic sympathectomy is the treatment of choice for primary hyperhidrosis and excessive facial blushing.
胸交感神经切除术对原发性腋窝和手掌多汗症以及面部潮红的根治有效，这些症状对患者来说可能非常困扰，以至于会影响他们的社交和职业关系。1988年10月至1994年4月期间，分别对5例和23例患者进行了总共50例胸交感神经切除术（10例手术切除和40例内镜手术）。手术均为单侧进行，6 - 8周后对侧进行干预。切除胸2 - 胸5神经节治疗多汗症。如果患者伴有面部潮红，则还切除星状神经节的下1/3。术后，所有手术侧的肢体均温暖干燥。在双侧手术的患者组中，只有1例仍有持续性面部潮红。因此，该系列中面部潮红的治疗有效率为93.3%。交感神经活动的晚期复发率为14.3%。67%的患者出现代偿性出汗，37.5%的患者出现味觉性出汗，29%的患者出现幻汗。他们中没有人认为这些副作用很麻烦。虽然经腋窝胸交感神经切除术和内镜手术在疗效方面没有差异，但后者术后疼痛较轻，住院时间较短，恢复较快。胸交感神经切除术是原发性多汗症和面部过度潮红的首选治疗方法。
