胸腔镜下T_3交感神经链及其侧支切断治疗手汗症  

Dissection of T_3 Sympathetic Nerve and Its Side Branch by Thoracoscopy for Palmar Hyperhidrosis

作　　者：李玉华[1] 朱彦君[1] 伍青[1] 张希东[1] 王桂洪[1] 宋清君[1] 

机构地区：[1]空军总医院胸外科,北京100142

出　　处：《中国微创外科杂志》2010年第6期496-498,共3页Chinese Journal of Minimally Invasive Surgery

摘　　要：目的探讨电视胸腔镜下T3交感神经链及其侧支切断术治疗手汗症的可行性。方法在全麻双腔气管插管下施行T3交感神经链及其侧支切断术治疗手汗症102例。结果全部手术顺利,101例术后手掌多汗症状立即消失;1例术后当天右侧手掌仍出汗,术后5d再次经右侧切口胸腔镜下切断神经残支。术前伴足底多汗94例、腋汗90例,术后症状消失或减轻分别为63例(67.0%)和85例(94.4%)。术中术后无严重并发症发生。术后45例(44.1%)出现不同部位轻度代偿性多汗,4例(3.9%)中度。结论电视胸腔镜下T3交感神经链及其侧支切断术治疗手汗症疗效确切,代偿性多汗发生率低,程度轻微,是一种安全、有效的手术方式。Objective To evaluate the feasibility and efficacy of dissection of T3 sympathetic nerve and its side branch by using thoracoscope for the treatment of primary palmar hyperhidrosis. Method Under general anesthesia with double-lumen intubation, T3 sympathectomy was performed on 102 patients by using thoracoscopy. Results The procedures was carried out successfully without severe morbidity in all of the patients. After the operation, the symptoms of palmar hyperhidrosis vanished immediately in 101 patients, only one patient remained right palmar hyperhidrosis and thus received a second operation to cut the residual sympathetic nerve. In the patients, 94 cases had food volar hyperhidrosis, and 90 showed axillary hyperhidrosis, 63 （67.0%） and 85 （94.4%） respectively of the patients had the symptoms disappeared or improved after the operation; meanwhile, mild and medium compensatory hyperhidrosis occurred in 45 （44.1%） and 4 （3.9%） of the patients respectively. ConclusionSympathectomy of the T3 level and its side branch by thoracoscopy is safe and effective for the treatment of primary palmar hyperhidrosis with low incidence rate of mild compensatory hyperhidrosis.

关 键 词：手汗症 胸交感神经链切断术 胸腔镜 

分 类 号：R655[医药卫生—外科学] R758.743[医药卫生—临床医学]