单孔法胸腔镜下胸交感神经链切断术治疗原发性手汗症  

Treatment of primary palmar hyperhidrosis with thoracoscopic sympathicotomy in single-hole

作　　者：张希东[1] 朱彦君[1] 李玉华[1] 伍青[1] 吴科[1] 于爱国[1] 刘杰[1] 吴文竹[1] 

机构地区：[1]空军总医院胸外科,北京100142

出　　处：《中国介入影像与治疗学》2013年第6期347-349,共3页Chinese Journal of Interventional Imaging and Therapy

摘　　要：目的探讨单孔法胸腔镜下胸交感神经链切断术治疗原发性手汗症的疗效及安全性。方法收集80例原发性手汗症患者,均接受单孔法胸腔镜双侧T4节段交感神经链切断术,喉罩通气,静吸复合全麻,于T4水平切断交感神经链,同时切断旁路传导纤维。手术前后监测患侧手掌皮温,术后评估手术疗效。结果全组80例患者均顺利完成手术,无死亡及严重并发症发生;术后出现少量气胸3例,乳糜胸1例。手术有效率100%,23例手掌完全干燥,57例在精神紧张和(或)环境温度过高时掌心略潮湿。13例术后出现转移性出汗,其中,胸背部位11例,臀部和大腿内侧部位7例(5例同时存在胸背部出汗),症状均轻微,未对患者术后生活造成不良影响。77例患者对疗效非常满意,2例满意,1例不满意。结论单孔法胸腔镜下胸交感神经链切断术治疗手汗症安全、有效,操作简单、创伤小、不良反应轻微,符合美学要求、患者满意度高。Objective To explore the curative effect and security of thoracoscopic sympathicotomy in single-hole for the treatment of primary palmar hyperhidrosis. Methods Bilateral T4 segment thoracoscopic sympathicotomy in single-hole was performed in 80 patients with primary palmar hyperhidrosis. Laryngeal mask airway and general anesthesia were done. The sympathetic chain at T4 segment was cut off, as well as the bypass conduction fiber. The patients＇ preoperative and postoperative temperature of palmar skin was measured. The efficacy of this treatment was evaluated after operation. Re-suits The operation was successfully completed in all 80 patients, no death nor severe complication occurred. There were 3 patients with a little pneumothorax, 1 patient with chylothorax after operation. The total effective rate was 100%. The palm bacame completely dry in 23 patients. Fifty-seven patients had slightly damp when they were nervous and/or at high temperature. Thirteen patients appeared metastatic perspiration after operation, 11 at chest and back, 7 at buttock and femoribus internus （5 patients with chest and back sweating）, all showed mild symptoms. There was no adverse effects on the patient＇s postoperative life. Seventy-seven patients were highly satisfied, 2 were satisfied and 1 was not satisfied. Con-clusion Thoracoscopic sympathicotomy in single-hole for the treatment of primary palmar hyperhidrosis is a safe and effec-tive method with simple operation, small trauma, mild adverse reaction, in line with the requirements of aesthetics and high patient satisfaction.

关 键 词：单孔 胸腔镜检查 交感神经 多汗症 

分 类 号：R651.3[医药卫生—外科学]