术中掌温升高小于1℃的原发性手汗症患者手术效果分析  

Surgical Effect Analysis of Primary Palmar Hyperhidrosis in Patients with Intraoperative Palm Temperature Rising Less Than 1℃

作　　者：王有钰[1] 龚立宏[1] 万延辉[1] 姚达[1] 吴昊 房福元 钱有辉[1] WANG You-yu;GONG Li-hong;WAN Yan-hui;YAO Da;WU Hao;FANG Fu-yuan;QIAN You-hui(The First Affiliated Hospital of Shenzhen University,Shenzhen Second People's Hospital,Guangdong Shenzhen 518035)

机构地区：[1]深圳大学第一附属医院深圳市第二人民医院,广东深圳518035

出　　处：《深圳中西医结合杂志》2021年第19期6-9,共4页Shenzhen Journal of Integrated Traditional Chinese and Western Medicine

基　　金：广东省卫生健康委员会-广东省医学科学技术研究基金项目资助课题(A2021441)。

摘　　要：目的:探讨行内镜下胸交感神经切断术(ETS)治疗原发性手汗症(PPH)时,术中掌温升高小于1℃患者的手术效果。方法:收集2018年2月至2020年9月在深圳大学第一附属医院行ETS治疗PPH的63例患者的临床资料,选择术中掌温升高<1℃的18例双侧第3肋(R3)ETS患者作为研究对象,分析其手术的临床效果及并发症。结果:患者术后第1天、第1周、第1年手汗、头汗、腋汗缓解率与术前比较,差异均具有统计学意义(P<0.05);患者术后足汗第1天缓解率与术前比较,差异具有统计学意义(P<0.05),术后第1周、第1年缓解率与术前比较,差异无统计学意义(P>0.05)。无围手术期血管损伤、霍纳综合征、大出血,但有3例轻度气胸,肺压缩在5%~15%,为术中气体排除不彻底,无需处理。术后1年随访1例双手过度干燥,冬季需使用润手霜;总代偿性多汗(CH)发生率为61.1%。结论:ETS治疗PPH,即使术中掌温升高小于1℃,也是安全、有效的。Objective To investigate the effect of intraoperative palmar temperature rising less than 1℃on endosocopic thoracic sympathectomy(ETS)for the treatment of primary palmar hyperhidrosis(PPH).Methods From February 2018 to September 2020,63 patients with PPH were treated with ETS in our hospital.Among of these,18 patients treated with bilateral R3(third rib)ETS whose palmar temperature increased less than 1℃during operation were selected,and their clinical effects and complications were analyzed.Results The hands were warm and dry on the first day,one week and one year after operation,and the effective rate was 100.0%.Compared with preoperatively,the remission rate of hand sweat,head sweat,and axillary sweat of the patients on the first day,week,and year after operation was statistically significant(P<0.05);The remission rate of foot sweat on the first day after operation was compared with that before operation,the difference was statistically significant(P<0.05),but the remission rate in the first week and year after operation was not significantly different from that before operation(P>0.05).There were no perioperative vascular injury,Horner syndrome or massive hemorrhage,but there were 3 patients with mild pneumothorax who had lung compression of 5%~15%,which was due to incomplete gas elimination during the operation and no treatment was required.At the twelve-month follow-up,one case required hand lotion due to excessive dry hands in winter;The total incidence of compensatory hyperhidrosis was 61.1%.Conclusion ETS is safe and effective in treatment of PPH,even if the intraoperative palmar temperature rising is less than 1℃.

关 键 词：原发性手汗症 掌温 胸交感神经切断术 内镜 

分 类 号：R658[医药卫生—外科学]