手足多汗症患者术后足温变化及与足汗缓解的关系  

Changes in temperature and sweating of plantar after needle transthoracic endoscopic t3-4 sympathectomy for hyperhidrosis

作　　者：李昀[1] 廖洪映[1] 韦正超[1] 张健[1] 余超[1] 蔡松旺[1] 翁毅敏[1] 谷力加[1] 

机构地区：[1]中山大学附属第三医院心胸外科,广东广州510630

出　　处：《中国内镜杂志》2010年第5期475-477,480,共4页China Journal of Endoscopy

摘　　要：目的探讨手足多汗症患者行针型胸腔镜双侧T3、T4交感神经链切断术后足温变化和足汗缓解的关系及可能机制。方法回顾性分析2007年12月～2008年10月该科收治的127例手足多汗症患者临床资料,所有患者均于双腔气管插管静脉吸入复合麻醉下行针型胸腔镜双侧T3、T4交感神经链切断术。术中连续监测足底温度,记录术前10min、术后10min足温。手术前1d及术后第1天分别采用多汗分级标准评定足汗严重程度。根据术后足温变化情况分为足温下降组(A组)、足温升高组(B组)及足温不变组(C组)3组。结果 3组患者术前、术后足温对比,差异无显著性(P>0.05)。A组85例,其中73例足汗缓解(85.9%),12例无明显变化。B组33例,其中15例足汗缓解(45.5%),18例无明显变化。C组9例,其中3例足汗缓解(33.3%),6例无明显变化。3组足汗缓解率两两比较,A组缓解率比其他两组明显增高(χ2=32.471,P=0.000;χ2=8.597,P=0.003)。B组和C组缓解率差异无显著性(χ2=0.000,P=1.000)。全组总有效率71.7%(91/127)。结论针型胸腔镜T3、T4交感神经链切断术可缓解部分手足多汗症患者足多汗情况,足温下降组足汗缓解率较高。[Objective]To investigate the relationship and mechanism between temperature and sweating of plantar after surgery. [Methods]127 patients with hyperhidrosis from December 2007 to October 2008 underwent bilateral transthoracic endoscopic T3-4 sympathectomy. There were 66 male and 61 female patients aged from 16～ 34 years （mean age 24.2 years）. Characteristics studied included changes in plantar skin temperature measured intraoperatively, as well as pre-and postoperative changes in planter sweating. The score of sweating was calculated by standard of Lai. plantar skin temperature were recorded for ten minutes the before and after surgery. All patients were divided into three groups according the change of temperature： decrease （Group A）, elevation （Group B） and no change （Group C）. [Results]In three groups, no obvious change of plantar temperature was demonstrated after surgery （P〉0.05）. There were 85 patients in Group A, in which remission rate of plantar sweating is 85.9% （73/85）. 33 patients in Group B, in which remission rate is 45.5% （15/33）. 9 patients in Group C, in which remission rate was 33.3% （3/9）. Remission rate of Group A was higher compared to the other two groups （χ2=32.471, P =0.000; χ2=8.597, P =0.003）. While no obvious change of remission rate was demonstrated between Group B and C （χ2=0.000, P =1.000）. Total remission rate is 71.7% （91/127）. [Conclusion]Needle transthoracic endoscopic T3-4 sympathectomy could relief plantar sweating obviously. Remission rate of plantar sweating is higher in group A.

关 键 词：手足多汗症 电视胸腔镜 交感神经链切断术 足温 

分 类 号：R655[医药卫生—外科学]