化学性胸交感神经节切除术治疗雷诺综合征97例  

Experience in treatment of Raynaud's syndrome by chemical sympathectomy:97 cases

作　　者：韩金涛[1] 赵军[1] 彭永光 

机构地区：[1]北京大学第三医院介入血管外科,北京100083 [2]河北省迁西县人民医院外二科

出　　处：《北京大学学报（医学版）》2008年第3期310-313,共4页Journal of Peking University:Health Sciences

摘　　要：目的:明确微创X线定位下化学性胸交感神经节灭活术治疗雷诺综合征的疗效。方法:97例雷诺综合征患者(186条上肢)在X线定位下局麻后经皮穿刺,于胸2交感神经节处注射5%(体积分数)苯酚2 mL。结果:首次治疗有效的肢体数为146条,占78.5%(146/186),首次治疗无效的肢体经二次治疗后有效者为13条,有效率为32.5%(13/40);住院患者首次住院总有效率为85.5%(159/186)。随访78例患者,随访率为80.4%(78/97),平均随访时间47个月,有效率为69.5%。并发症的发生率分别为:气胸11.4%,胸腔积液3.9%,胸前区及腋部痛觉过敏、Horner综合征及窦性心动过缓均少见。结论:化学性胸交感神经灭活术治疗雷诺综合征是一种微创有效的治疗方法。Objective： To summarize the curative effect in treatment of Raynaud＇ s syndrome with chemical thoracic sympathectomy （CTS） guided by X-ray since 2001. Methods： From March 2001 to August 2007, 97 patients with Raynaud＇ s syndrome （ 186 limbs） were treated by CTS. Guided by X- ray, a needle was punctured through the back skin to the second thoracic sympathetic ganglion beside the thoracic vertebrae and 2 mL of 5% （v/v） phenol was injected. Results： The first CTS treatment produced a good effect on 146 limbs with an effective rate of 78.5% （146/186）. The same treatment was performed on the limbs with no effect 1 -2 days after the first treatment and produced good effect on 13 limbs with an effective rate of 32. 5% （13/40）. The total effective rate of the patients who were hospitalized for the first time was 85.5% （159/186）. Of the 97 patients, 78 patients （80.4%） were followed up for 47 months on an average with an effective rate of 69.5%. And the rate of complications was 11.4% for pheumothorax, and 3.9% for hydrothorax. Hyperalgesia on axillary region and anterior chest wall; Homer syndrome and sinus bradycardia were rare. Conclusion： CTS is minimally invasive and effective in treatment of Raynaud＇ s syndrome.

关 键 词：雷诺病 交感神经切除术 化学 外科手术 微创性 

分 类 号：R747.3[医药卫生—神经病学与精神病学]