胸腔镜下T4胸交感神经链切断术治疗原发性手汗症的临床研究  

Clinical Study of T4 Thoracic Sympathectomy under Thoracoscope in the Treatment of Primary Palmar Hyperhidrosis

作　　者：许博[1] 陈献国[1] 王叶萍[1] 楼洋[1] 李献帅 徐小义 XU Bo;CHEN Xianguo;WANG Yeping;LOU Yang;LI Xianshuai;XU Xiaoyi(Jinhua Municipal Central Hospital,Zhejiang 321000,China)

机构地区：[1]金华市中心医院,浙江金华321000

出　　处：《浙江医学教育》2020年第3期48-50,54,共4页Zhejiang Medical Education

摘　　要：目的:比较胸腔镜下T3及T4胸交感神经链切断术治疗原发性手汗症的手术效果,分析T4平面胸交感神经链切断术的治疗优势。方法:将我院80例原发性手汗症手术患者随机分为T3组及T4组,比较2组手术有效率、手术并发症、术后转移性多汗(TH)、术后生活质量评分等情况。结果:2组手术治疗有效率100%,T4组总TH发生率(32.5%)低于T3组(70%),T4组中度、重度TH发生率(10%、2.5%)均明显低于T3组(40%、15%);2组患者术后生活质量评分较术前均有下降,T4组下降幅度较T3组更为明显,差异均有统计学意义(P<0.05)。结论:胸腔镜下T4胸交感神经链切断术治疗原发性手汗症安全有效,术后中度、重度转移性多汗发生率低,对患者的生活质量起到明显改善作用,值得临床推广。[Objective]By comparing the surgical effects of thoracoscopic T3 and T4 thoracic sympathectomy in the treatment of primary palmar hyperhidrosis, the advantages of T4 plane cut were summarized.[Method]80 patients with primary hand sweat surgery in our hospital were randomly divided into T3 group and T4 group.The surgical efficiency, surgical complications, postoperative transfer hyperhidrosis and postoperative quality of life scores were compared between the two groups.[Result]The effective rate of surgical treatment was 100% in the two groups.The incidence of TH in T4 group(32.5%) was lower than that in T3 group(70%), and the incidence of moderate and severe in T4 group(10%, 2.5%) was lower than that in T3 group(40%, 15%). The postoperative quality of life scores of the two groups were lower than those before surgery, and the decline was more significant in the T4 group than in the T3 group, and the differences were statistically significant(P<0.05).[Conclusion]T4 thoracic sympathectomy under thoracoscopy is safe and effective in the treatment of primary palmar hyperhidrosis. The incidence of moderate and severe transfer hyperhidrosis after surgery is low, which significantly improves the quality of life of patients and is worthy of clinical promotion.

关 键 词：原发性手汗症 胸交感神经链切断术 转移性多汗 

分 类 号：R655[医药卫生—外科学]