自制穿刺式电刀在微型胸腔镜治疗手汗症中的应用  

Needlescopic Video-Assisted Thoracoscopic Sympathectomy with a Self-made Needle-shaped Electrotome for Palmar Hyperhidrosis

作　　者：马日新[1] 曾格林[1] 吕庆帮[1] 

机构地区：[1]广东省江门市人民医院胸外科,江门529000

出　　处：《中国微创外科杂志》2012年第9期843-844,共2页Chinese Journal of Minimally Invasive Surgery

摘　　要：目的探讨微型胸腔镜下用穿刺式电刀行胸交感神经切断术治疗手汗症的可行性。方法 2005年3月～2010年2月,用克氏针加绝缘胶套自制成穿刺式电刀,在2 mm胸腔镜监视下,用穿刺式电刀在第4肋间腋中线处穿刺进入胸腔,行双侧T3、T4交感神经切断术治疗37例手汗症。结果 37例手术均获成功,手术时间27～40 min,平均32 min。术后3～5 d出院,平均4.5 d。术后5例少量气胸,其中1例须胸腔穿刺。随访6～24个月,平均18个月,无复发,双手干燥1例,躯干代偿性多汗4例。结论微型胸腔镜下用穿刺式电刀行胸交感神经切断术治疗手汗症可行,疗效确切,创伤小,安全性高。Objective To investigate the feasibility of needleseopie video-assisled thoraeoseopie sympatheetomy with a needle-shaped eleetrotome for palmar hyperhidrosis. Methods Since March 2005 to February 2010, in 37 patients with plamar hyperhidrosis,with a needle-shaped eleetrotome made of Kirsehner wire and insulating tape, we made puncture into the thoracic eavit under a 2-ram Ihoraeoseope, at the 4th intercostal space on the midaxillary line, so that to eat the bilateral 3 and T4 syml：}alhetie nerves. Results The procedure was completed in all the patients within a mean of 32 minutes （ranged from 27 to 40 minutes）. The patients were discharged form hospital in 3 to 5 days after the operation （mean, 4.5 days）. Fiw, patients had mihl pneumothtorax after the procedure, and one of them had to receive thoracic puncture to relieve the symptom. A follnw-up for a mean of 18 months （ranged from 6 to 24 months） were achieved in all the patients; during the period, no recurrence was reported, one patients complained of dry pahnar, anti four patients showed compensatory sweating. Conclusion Needleseopic video-assisted thnraecseopie sympatlleetomy witl a needle-shaped electrotome is effective, safe, and minimally invasive for palmar hyperhidrosis.

关 键 词：穿刺式电刀 胸腔镜 手汗症 胸交感神经切断术 

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