经脐胸交感神经切断术1年随访  

Transumbilical thoracic sympathectomy for hyperhidrosis： one year follow-up

作　　者：杨胜生[1] 朱立桓[1] 陈龙[1] 张吉学[1] 刘道明[1] 冯学刚[1] 程先进[1] 李达周[2] 陈炜生[1] 

机构地区：[1]中国人民解放军南京军区福州总医院外科,福州350000 [2]中国人民解放军南京军区福州总医院消化科,福州350000

出　　处：《中华胸心血管外科杂志》2013年第7期408-410,共3页Chinese Journal of Thoracic and Cardiovascular Surgery

摘　　要：目的回顾性总结经脐胸交感神经切断术（transumbilical thoracic sympathectomy，1rrs）1年随访结果，评估采用Trs技术的手术效果。方法2010年4月至2011年8月，38例手汗症患者接受经脐胸交感神经切断术，男17例，女21例；年龄14—35岁，平均22岁。单纯手汗22例，手汗合并腋汗16例。从治愈率、疼痛持续时间、术后满意率以及并发症发生率等方面进行随访。结果38例手术均成功完成，手术40～86min，平均47min；术中无严重并发症发生。35例随访1．0～1．6年，平均1．2年。所有手汗症均达到临床治愈，腋汗治愈率81．3％（13／16例），总复发1例（2．9％）；代偿性出汗10例（28．6％），气胸2例（5．7％），刀口疼痛平均持续时间2天；无霍纳综合征、膈疝等并发症发生。结论经脐内镜下胸部交感神经切断术治疗手汗症安全、可行，远期疗效稳定，可为部分人群提供新的手术入路选择。Objective To summarize the one year followup clinical result of patients undergoing endoscopic transumbil ieal thoracic sympatheetomy and to assess the related factors influencing the outcome. Methods A total of 38 patients （ 17 males, 22 females） with a mean age of 22 years old underwent transumbilieal thoracic sympathectomy from April 2010 to Au gust 2011. Of these, 16 patients suffered concomitant palmar and axillary hyperhidrosis and 22 palmar hyperhydrosis alone. The following parameters were evaluated ： clinical improvement, satisfaction, changes in quality of life, and compensatory swea ting and gustatory sweating. Results The operation was accomplished successfully in all 38 patents with a mean operation time of 47 rain （40 86 rain）. 35 patients were followed up for 1.0 1.6years （ mean 1.2 years）. The rate of palmar hyperhidmsis （PH） and axillary hyperhidrosis （AH） resolution was 100% and 81.3% , respectively, and recurred in 1 patient. Postopera tive complications were noticed in 12 patients, including compensatory sweating in 10 cases and pnenmothorax in 2 cases. The postoperative pain lasts less than 2 days in all patients. There was no Homer syndrome and no diaphragmatic hernia was ob served. Conclusion Endoscopic transumbilical thoracic sympathectomy is a safe and efficacious alternative to the conventional approach.

关 键 词：胃镜检查 交感神经切断术 多汗症 随访研究 

分 类 号：R655[医药卫生—外科学]