手汗症患者手术前后脑血流灌注显像研究  

Characteristics of cerebral regional blood flow in patients with palmar hyperhidrosis

作　　者：涂远荣[1] 李旭[1] 林敏[1] 赖繁彩[1] 陈剑锋[1] 邱明链[1] 

机构地区：[1]福建医科大学附属第一医院胸外科福建医科大学手汗症研究室,福州350005

出　　处：《中华实验外科杂志》2009年第4期489-490,共2页Chinese Journal of Experimental Surgery

基　　金：福建省科技厅重点项目（2007Y0015）;福建省教育厅B类项目（JB07121）

摘　　要：目的观察手汗症患者手术治疗前后脑血流灌注特点，探讨手汗症中枢神经系统的可能发病机制。方法采用单光子发射断层扫描（SPECT）方法，对10例手汗症患者行胸交感神经切断术前后的脑血流灌注进行半定量分析，观察术前脑血流灌注特点并比较手术前后的血流灌注变化。结果10例术前患者中有9例表现为一侧基底节脑血流灌注增高，其中轻度增高1例，明显增高8例。放射性增高灶术前Ra值为（1．70±0．19），手术后下降为（1．10±0．06），平均下降值为（42．00±6．92）％（P〈0．05）。结论基底节神经功能活动与手汗症的发病及术后代偿性多汗的出现有一定关系。Objective To observe the characteristics of cerebral regional blood flow （rCBF） in the patients with palmar hyperhidrosis, and to explore the possible mechanism for the development of palmar hyperhidrosis. Methods SPECT 99Tcm-ECD was used to quantitatively determine rCBF of patients with palmar hyperhidrosis who underwent endoscopic thoracic sympathectomy. The preoperative rCBF mode was analyzed, and the preoperative and postoperative mode of rCBF was compared. Results The one lateral high rCBF zone was observed at basal nucleus area in 9 cases out of 10 cases. The blood flow of high rCBF zones was significantly decreased after sympathectomy （ Ra value 1.7.0 ± 0.19 vs 1.10 ± 0.06 ,P 〈 0.05）. The blood flow change rate was （42.00 ± 6.92） %. Conclusion The basal nucleus may play an important role in the development of palmar hyperhidrosis and compensatoy sweating.

关 键 词：手汗症 脑血流 单光子发射断层扫描 胸交感神经切断术 

分 类 号：R655[医药卫生—外科学]