胸腔镜下交感神经链切断术两种麻醉方法对手汗症康复的影响  

作　　者：郑兆伟 潘秋霞 董礼文[1] 杨勇[1] 

机构地区：[1]杭州市中医院,310000 [2]杭州市余杭区第五人民医院,310000

出　　处：《浙江临床医学》2018年第8期1356-1357,共2页Zhejiang Clinical Medical Journal

摘　　要：目的探讨胸腔镜下交感神经链切断术两种麻醉方法（喉罩麻醉和单腔导管麻醉）对手汗症术后快速康复的影响。方法选取2013年8月至2017年2月入院行胸腔镜双侧T4交感神经链切断术的64例原发性手汗症患者，按麻醉方式分为喉罩麻醉组（A组）与单腔导管麻醉组（B组）两组，A组32例，B组35例。结果所有入组患者术后手汗症状明显改善，均未发生心脑血管意外及霍纳综合征等严重并发症。A纽和13组在手术时间、术中出血量、术后代偿性多汗发生率的比较中均无明显统计学差异（P〉0．05）；但A组术后疼痛评分较B组明显降低，术后咳嗽持续时间明显减少，术后住院时间明显缩短，差异均有统计学意义（P〈0.05）。结论喉罩麻醉较单腔导管麻醉对手汗症手术患者的创伤更小，患者术后恢复更快，更符合快速康复外科理念。Objective To explore the effect of laryngeal mask anesthesia and single lumen catheter anesthesia in the postoperative fast track of palmar hyperhidrosis. Methods Sixty-seven patients with primary palmar hyperhidrosis treated by thoracoscopic bilateral T4 sympathectomy from Aug 2013 to Feb 2017 were divided into two groups： Group A （ n=32 ） ： the laryngeal mask anesthesia, Group B （ n=35 ） ： the single lumen catheter anesthesia. Results The symptom of palmar hyperhidrosis of all the patients were obviously alleviated, none of them had serious complications such as cerebrovascular accident and Horner＇s syndrome. There was no significant difference between group A and B in surgical time, blood volume, and postoperative compensatory hyperhidrosis （P〉0.05） . But the postoperative pain score of group A was significantly lower than group B, the duration of postoperative cough was reduced obviously, the postoperative hospitalization time was significantly shorten （ P〈0.05 ） . Conclusion Laryngeal mask anesthesia has less trauma for patients than single lumen catheter anesthesia, and significantly improves the quality of life postoperatively, which is more consistent with fast track surgery.

关 键 词：手汗症 胸腔镜 喉罩麻醉 单腔导管麻醉 快速康复 

分 类 号：R735.905[医药卫生—肿瘤]