经脐超细胃镜下胸交感神经毁损术治疗女性手汗症25例临床观察  

Thoracic sympathectomy by Natural Orifice Trans Umbilical Surgery （NOTUS） for woman patients with palmar hyperhidrosis

作　　者：陈炜生[1] 朱立桓[2] 李达周[3] 冯学岗 张吉学[1] 刘道明[1] 王雯[3] 

机构地区：[1]南京军区福州总医院胸心外科,福州350025 [2]济南军区总医院胸外科 [3]南京军区福州总医院消化科

出　　处：《中华消化内镜杂志》2014年第6期301-303,共3页Chinese Journal of Digestive Endoscopy

摘　　要：目的探讨经脐超细胃镜下胸交感神经毁损术治疗女性手汗症的安全性和临床应用价值。方法对25例女性手汗症患者行经脐超细胃镜下胸交感神经毁损术治疗，记录手术完成情况、手术时间、并发症发生情况，术后随访观察治疗效果。结果25例均顺利完成手术，术中患者生命体征平稳，手术时间58～113min，平均64min。无膈疝、脐疝发生，无霍纳氏综合征和血胸等严重并发症发生，仅3例术后并发少量气胸。出院后1周所有患者恢复学习和工作，脐部手术瘢痕小而隐匿，体表基本无可见切口。随访4～12个月，所有患者手部多汗症状完全消失，腋汗症状6例完全消失、4例明显改善、1例轻微好转。结论经脐超细胃镜下胸交感神经毁损术治疗手汗症安全有效，术后瘢痕小而隐匿，更加适合爱美的女性。Objective To investigate the clinical value of transumbilical endoscopic thoracic sympa- thectomy on women patients with palmar hyperhidrosis. Methods A total of 25 consecutive women patients with palmar hyperhidrosis underwent transumblical thoracic sympathectomy with ultra-thin endoscope. The operative data, including duration of operation, intra-operative and postoperative complications were recor- ded. Results The procedure was performed successfully in all 25 patients with a mean operative time of 64 min（58-113 min）. No umbilical hernia, diaphragmatic hernia, Homer＇s syndrome or hemothorax were observed. Minor pneumothorax was found in postoperative chest X-ray in 3 patients, all of which were com- pletely resolved with conservative treatment. All patients recovered to their normal life at 1 week after dis- charge. The scar was small and hidden in umbilical with no visible incisions. After a follow-up of 4 to 12 months, all patients＇ hands sweating symptoms completely disappeared, axillary sweat symptoms completely resolved in 6 patients, significantly improved in 4 and mildly improved in 1. Conclusion Trans- umbilical thoracic sympathectomy with ultrathin flexible endoscope is a safe and effective option for women patients with severe palmar hyperhidrosis, which provides excellent cosmetic outcomes.

关 键 词：手汗症 内镜外科 超细胃镜 

分 类 号：R651.3[医药卫生—外科学]