电视纵隔镜与胸腔镜胸交感神经链切断术治疗手汗症的比较  

Thoracic sympathectomy under Video-Mediastinoscopy and Video-assisted thoracoscopy for palmar hyperhidrosis

作　　者：叶国麟[1] 杨劼[1] 谭家驹[1] 李文军[1] 古卫权[1] 潘瑞琳[1] 朱乐伟[1] 

机构地区：[1]广东省佛山市第一人民医院胸外科,广东佛山528000

出　　处：《河北医学》2004年第10期897-899,共3页Hebei Medicine

摘　　要：目的 :探讨电视纵隔镜胸交感神经链切断术治疗手汗症的可行性。方法 :气管插管全麻 ,30°～ 4 5°半坐位 ,两臂外展 90°,电视纵隔镜从腋前线第 3肋间小切口置入 ,电钩切断T2～T4交感神经链。结果 :手术时间 2 0～ 4 0min ,平均 30min。单纯手汗合并而部及腋窝多汗均消失 ,双手温度上升0 .8～ 3.0℃ ,温暖而干燥。住院 3～ 30d ,平均 3.5 4d。无严重并发症发生 ,1例气胸需较长时间胸腔引流 ,背部代偿性多汗 34例。结论 :电视纵隔镜胸交感神经链切断术治疗手汗症可行。比常规电视胸腔镜减少 1～ 2个切口 ,操作简单 ,病人易于接受 ,可部分取代电视胸腔镜手术。Objective: To explore the feasibility of thoracic sympathectomy under Video-Mediastinoscopy (VM) for palmar hyperhidrosis. Method: Under general anesthesia with endotracheal tubeplacement .The patients were maintained in the 30°～45° semi-sitting position , with abduction of both arms to 90°. The VM entered the thoracic cavity via the third intercostals space on the anterior axillary line .The T2～T4 sympathetic ganglions were resected by electrocautery . Result:Hyperhidrosis disappeared post operatively in all the cases. The temperature of patients ’ both hands increased by 1.5～3.0℃ .The operation time was 20～40min (mean,30min) and the hospital stay was 3～30d(mean, 3.54d). No severe complications occurred. Conclusion:Thoracic sympathectomy under VM is less invasive and simple than that under video-assisted thoracoscopic surgery (VATS) in the treatment of Palmar hyperhidrosis,being a feasible alternative.

关 键 词：电视纵隔镜 胸交感神经链切断术 手汗症 

分 类 号：R655[医药卫生—外科学]