胸腔镜下胸交感神经干切断术治疗手汗症（附300例报告）  

Endoscopic thoracic sympathectomy： a clinical research of 300 cases

作　　者：涂远荣[1] 李旭[1] 林敏[1] 赖繁彩[1] 陈剑锋[1] 叶建刚[1] 代祖建[1] 

机构地区：[1]福建医科大学附属第一医院胸外科,福州350005

出　　处：《中华神经外科杂志》2007年第2期142-145,共4页Chinese Journal of Neurosurgery

基　　金：福建医科大学科研项目资助（FJGXQ04006）

摘　　要：目的 总结胸腔镜胸交感神经干切断术300例的临床经验。方法 分析2003年1月至2006年1月经胸腔镜胸交感神经干T2～T4切断术治疗手汗症的临床资料。以患侧手掌皮肤温度较术前升高1℃～3℃或更高，转干燥者为有效。手掌皮肤温度较术前增加小于1℃仍为潮湿者为无效。结果 300例手术均获成功，术后患者手掌多汗症状消失，双手转为干燥温暖状，术后掌温升高（2．8±0.8）℃；282例术后随访1-36个月无一例复发，术后转移代偿性多汗60例占21．2％。结论 胸交感神经干切断术是治疗手汗症安全、微创和有效的方法。Objective To summarize the experience on 300 cases endoscopic thoracic sympathectomy （ETS）. Methods Clinical materials of T2 - T4 sympathectomy under thoracoscope for treating palmar hyperhidrosis from January 2003 to January 2006 were analysed. The evaluation was decided by the results that if the temperature of injury hands skin raised 1℃- 3℃ or more before operation it was considered effective for the dry hands; therwise if the temperature of the injury hands raised less than 1℃, it was considered noneffective for the moist hands. Result All the 300 cases were successfully operated on. Symptoms of hyperhidrosis vanished with both hands dry and warm in all the patients. Plamar temperature increased by a mean of （2.8 -0.8）℃ after operation. Follow up observations in 282 cases for 136 months （mean, 18.4 months） showed no recurrence. Compensatory hyperhidrosis was found in 60 cases （21.2% ）. Conclusion Endoscopic thoracic sympathectomy is a safe, effective, and micro-invasive treatment for palmar hyperhidresis.

关 键 词：交感神经切除术 多汗症 手 胸腔镜外科手术 

分 类 号：R686[医药卫生—骨科学]