胸交感神经链切断术治疗原发性手汗症的疗效分析  

Effect analysis of sympathectomy in the treatment of primary palmar hyperhidrosis

作　　者：吴浩[1] 朱彦君[1] 张希东[1] 李彩伟[1] 

机构地区：[1]中国人民解放军空军总医院胸外科,北京100142

出　　处：《现代医学》2015年第9期1110-1113,共4页Modern Medical Journal

摘　　要：目的:比较胸腔镜下不同节段胸交感神经切断术对原发性手汗症的治疗效果。方法:225例原发性手汗症患者在我院接受了胸腔镜下胸交感神经链切断术,其中第3肋骨表面交感神经链(R3)切断术(R3组)112例,第4肋骨表面交感神经链(R4)切断术(R4组)113例,比较两组术后手部出汗、复发情况、代偿性多汗及患者满意度等,并进行统计学分析。结果:术后手汗症缓解R3组110例,R4组111例,两组各有2例复发。两组代偿性多汗的发生率分别为69.64%、49.56%,其中重度代偿性多汗发生率分别为9.8%、0.9%,两组比较差异有统计学意义(P<0.05)。术后两组满意度得分分别为(8.20±1.24)分和(8.44±1.25)分,两组比较差异无统计学意义(P>0.05)。结论:胸腔镜下R4切断术可有效地缓解手部多汗症状,同时代偿性多汗的发生率低,是治疗原发性手汗症较理想的方法。Objective： To compare the effect of thoracoscopic sympathectomy at different sgements in the treatment of primary palmar hyperhidrosis. Methods： There were 225 patients accepted thoracoscopic sympathectomy for primary palmar hyperhidrosis in our hospital. A total of 112 patients received third rib surface sympathetic trunk（ R3） sympathectomy（ group R3）,while 113 patients underwent forth rib surface sympathetic trunk（ R4）sympathectomy（ group R3）. The situation of palmar sweating,whether relapse,compensatory hyperhidrosis and the satisfaction of patients were compared between the two groups,then the data was statistically analyzed. Results：110 cases palmar hyperhidrosis was resolved after R3 sympathectomy and 111 cases was resolved after R4 sympathectomy. There were 2 cases recurrence in both groups. The rate of compensatory hyperhidrosis was 69. 9%in group R3 and 49. 56% in group R4,severe compensatory hyperhidrosis incidence was 9. 8% and 0. 9%,which was statistically significant（ P 〈 0. 05）. The satisfication record was 8. 20 ± 1. 24 and 8. 44 ± 1. 25,there was no significant difference（ P 〉 0. 05）. Conclusions： Thoracoscopic R4 sympathectomy can resolve palmar sweating and has low incidence of compensatory hyperhidrosis. It is recommended for treatment of primary palmar hyperhidrosis.

关 键 词：原发性手汗症 交感神经链切断术 代偿性多汗 

分 类 号：R651.3[医药卫生—外科学]