原发性手掌多汗症患者胸交感神经切除术后交感神经皮肤反应的变化  

Changes in the sympathetic skin response after thoracoscopic sympathectomy in patients with primary palmar hyperhidrosis

作　　者：Lladó A. León L. Valls-Sdé J. 夏峰 

机构地区：[1]Unitat d'EMG , Servei de Neurologia, Hospital Clnic, Villarroel, 170, Barcelona 08036, Spain

出　　处：《世界核心医学期刊文摘（神经病学分册）》2005年第10期12-12,共1页Digest of the World Core Medical Journals:Clinical Neurology

摘　　要：Objective: To investigate whether thoracic sympathectomy induced any change i n the pattern of abnormalities or in the waveform of the sudomotor skin response (SSR) in patients with primary palmar hyperhidrosis (PPH). Methods: We recorded the SSR to median nerve electrical stimuli before and after bilateral thoracosc opic sympathectomy in 27 patients with PPH. We analyzed the changes in amplitude , type of waveform and pattern of abnormality. Results: All patients reported sy mptomatic improvement. The amplitude of the SSR decreased significantly in patie nts examined within 1 year after surgery, but was not different in patients exam ined after 1 year. The number of abnormally enhanced responses reduced after sur gery, but there was no significant change in the number of patients with enhance d excitability recovery or with double- peak responses to single stimuli. There was a significant increase in the number of SSRs with a predominantly negative waveform after surgery. Conclusions: The persistence of SSR abnormalities after surgery suggests that the central nervous system dysfunction is not modified by sympathectomy. The change of the waveform to predominantly negative type after s urgery could be the consequence of the decrease in the production of sweating. S ignificance: Our results show the effects of sympathectomy on the SSR and on its abnormal patterns in patients with PPH.Objective: To investigate whether thoracic sympathectomy induced any change i n the pattern of abnormalities or in the waveform of the sudomotor skin response (SSR) in patients with primary palmar hyperhidrosis (PPH). Methods: We recorded the SSR to median nerve electrical stimuli before and after bilateral thoracosc opic sympathectomy in 27 patients with PPH. We analyzed the changes in amplitude , type of waveform and pattern of abnormality. Results: All patients reported sy mptomatic improvement. The amplitude of the SSR decreased significantly in patie nts examined within 1 year after surgery, but was not different in patients exam ined after 1 year. The number of abnormally enhanced responses reduced after sur gery, but there was no significant change in the number of patients with enhance d excitability recovery or with double- peak responses to single stimuli. There was a significant increase in the number of SSRs with a predominantly negative waveform after surgery. Conclusions: The persistence of SSR abnormalities after surgery suggests that the central nervous system dysfunction is not modified by sympathectomy. The change of the waveform to predominantly negative type after s urgery could be the consequence of the decrease in the production of sweating. S ignificance: Our results show the effects of sympathectomy on the SSR and on its abnormal patterns in patients with PPH.

关 键 词：手掌多汗症 交感神经切除术 电刺激 皮肤反应 患者数量 系统功能障碍 正中神经 试验结果 

分 类 号：R758.743[医药卫生—皮肤病学与性病学]