普通胃镜和超细胃镜在经脐胸交感神经毁损术中的应用比较  

Comparation of ordinary gastroscopy and ultrafine gastroscopy in transumbilical thoracic sympathectomy

作　　者：李达周[1] 陈飞[1] 陈炜生[2] 杨胜生[2] 王雯[1] 

机构地区：[1]南京军区福州总医院消化内科福建医科大学福总临床医学院,350025 [2]南京军区福州总医院心胸外科

出　　处：《中国临床实用医学》2014年第6期19-21,共3页China Clinical Practical Medicine

基　　金：南京军区医学科技创新重大项目（12Z35）

摘　　要：目的：比较普通胃镜和超细胃镜在经脐经膈肌胸交感神经毁损术治疗手汗症中的应用。方法选择南京军区福州总医院2012年1月至2013年12月收治的原发性重度手汗症患者64例，将其分为普通胃镜组和超细胃镜组，各32例。两组均行经脐经膈肌进入胸腔行双侧T3交感神经毁损术。记录手术时间、膈肌切口出血情况、术后住院时间，于1、6、12个月随访记录患者术后手汗情况、并发症、疤痕大小及满意率。结果64例患者均顺利完成手术，没有出现死亡和术中改开胸手术病例。普通胃镜组和超细胃镜组平均手术时间分别为（54.59±1.49）min、（53.53±1.09）min，两组差异无统计学意义（P>0.05）。两组平均住院时间均为1.5 d。术后随访12个月，两组均未观察到膈疝、脐疝、霍纳综合症等严重并发症发生，无术后手汗症复发、重度代偿性多汗。术后1个月疤痕普通胃镜组隐约可见，超细胃镜组非常轻微；术后6个月普通胃镜组疤痕非常轻微，超细胃镜组基本无疤痕。普通胃镜组和超细胃镜组的满意率分别为75.00%（24/32）和96.88%（31/32），两组相比差异有统计学意义（P<0.05）。结论普通胃镜和超细胃镜经脐经膈肌胸交感神经毁损术治疗原发性手汗症安全、有效、可行、美观，超细胃镜组患者术后满意度更高。ObjectiveTo compare the application of ordinary gastroscopy and ultrafine gastroscopy in sympathectomies which usded to treat severe palmar hyperhidrosis.MethodsFrom January 2012 to December 2013,a total of 64 patients with primary severe palmar hyperhidrosis were randomly divided into ordinary gastroscopy group (32 cases)and ultrafine gastroscopy group (32 cases).There is no difference between two groups.All of the patients were underwent transumbilical diaphragmatic T3 thoracic sympathectomy.Follow-up at 1,6,12 months,recording the operation time,diaphragmatic incision bleeding, postoperative hospital stay, patients'' hands sweat, complications, scar size and satisfaction.Results64 patients were successfully operated, no patient deaths and no patient change to thoracotomy. The average operative time:ordinary gastroscopy group (54.59±1.49)min, ultrafine gastroscopy group (53.53±1.09)min. Two groups have no significant difference (P>0.05). The mean postoperative hospital stay were 1.5 days. Patients were followed up for 12 months, both groups were not observed diaphragmatic hernia, umbilical hernia, Horner''s syndrome , no recurrence of palmar hyperhidrosis, severe compensatory sweating and other serious complications. 1 month after this operation,the scar in ordinary gastroscopy group almost invisible,while in ultrafine gastroscopy group basically invisible,6 month after the operation,the scar in ordinary gastroscopy group invisible, ultrafine gastroscopy group almost no scarring. Satisfaction survey shows ordinary gastroscopy group is 75.00%(24/32),sultrafine gastroscopy group is 96.88%(31/32),there is significant difference between the two groups (P<0.05).ConclusionUse ordinary gastroscopy and ultrafine gastroscopy transumbilicaldiaphragmatic T3 thoracic sympathectomy for primary palmar hyperhidrosis treatment is safe, effective,feasible and beautiful.In the ultrafine gastroscopy group,the percentage of operative satisfaction is higher than ordinary gastroscopy group.

关 键 词：普通胃镜 超细胃镜 原发性手汗症 交感神经毁损术 

分 类 号：R[医药卫生]