胸腔镜下第三与第四胸交感神经干切断术在治疗手汗症患者中的疗效对比  

Comparison of the Efficacy of Thoracoscopic Third and Fourth Thoracic Sympathectomy in the Treatment of Palmar Hyperhidrosis

作　　者：江文坛[1] 杨建胜 林良安[1] 吴敬阳 林贤宾 JIANG Wen-tan;YANG Jian-sheng;LIN Liang-an;WU Jing-yang;LIN Xian-bin(Department of Thoracic Surgery,the Second Affiliated Hospital of Fujian Medical University,Quanzhou,Fujian Province,362000 China)

机构地区：[1]福建医科大学附属第二医院胸外科

出　　处：《中外医疗》2019年第33期79-81,共3页China & Foreign Medical Treatment

摘　　要：目的对比胸腔镜下第三(T3)与第四(T4)胸交感神经干切断术在治疗手汗症患者中的疗效。方法回顾性分析2008年8月—2018年8月该院收治的202例手汗症患者的临床资料,依据手术方式的不同分为T3组(n=101)和T4组(n=101)。其中T3组给予胸腔镜下T3交感神经干切断术进行治疗,T4组给予胸腔镜下T4交感神经干切断术进行治疗。比较分析两组患者治疗后的临床疗效、治疗前后的手掌皮肤温度和术后转移性多汗情况及远期疗效。结果T4组的临床治疗总有效率为99.01%,T3组的临床治疗总有效率为100.00%,比较差异无统计学意义(χ2=1.005,P=0.316)。两组患者术前手掌皮肤温度比较差异无统计学意义(t=0.199,P=0.843)。手术后均显著升高,且T4组低于T3组,比较差异无统计学意义(t=0.188,P=0.851)。T4组术后转移性多汗率显著低于T3组,比较差异有统计学意义(χ2=10.100,P=0.002)。T4组术后随访6个月的复发率为3.00%,高于T3组的1.98%,比较差异无统计学意义(χ2=0.215,P=0.643)。结论胸腔镜下T3、T4交感神经干切断术疗效确切,而T4交感神经干切断术能够明显降低术后转移性多汗率,远期疗效接近,值得在临床上大力推广。Objective To compare the efficacy of thoracoscopic third and fourth thoracic sympathectomy in the treatment of palmar hyperhidrosis.Methods The clinical data of 202 patients with palmar hyperhidrosis admitted from August 2008 to August 2018 were retrospectively analyzed.They were divided into T3 group(n=101)and T4 group(n=101)according to different surgical methods.T3 group received thoracoscopic T3 sympathectomy for treatment,T4 group received thoracoscopic T4 sympathectomy for treatment.The clinical efficacy,palm skin temperature,metastatic hyperhidrosis and long-term efficacy of the two groups after treatment were compared and analyzed.Results The total effective rate of T4 group was 99.01%,and that of T3 group was 100.00%,there was no statistically significant difference(χ2=1.005,P=0.316).There was no statistically significant difference in preoperative palm skin temperature between the two groups(t=0.199,P=0.843).Palm skin temperature all increased significantly after surgery,and T4 group was lower than T3 group,but there was no statistically significant difference(t=0.188,P=0.851).The rate of metastatic hyperhidrosis in group T4 was significantly lower than that in group T3(χ2=10.100,P=0.002).The recurrence rate of T4 group was 3.00%after 6 months follow-up,which was higher than 1.98%in T3 group,but there was no statistically significant difference(χ2=0.215,P=0.643).Conclusion Thoracoscopic sympathectomy of T3 and T4 has definite curative effect,while T4 sympathectomy can significantly reduce the rate of metastatic hyperhidrosis after operation.The long-term curative effect is close,and it is worth popularizing in clinic.

关 键 词：胸腔镜 胸交感神经干切断术 手汗症 

分 类 号：R655[医药卫生—外科学]