超微5mm单孔胸腔镜交感神经链切断术在原发性手汗症手术中的临床应用  

Clinical application of ultra-micro 5 mm single-port endoscopic thoracic sympathicotomy in selected patients with primary palmar hyperhidrosis

作　　者：邵广强 庞大志 张吉天 李敬龙 王红霞 刘智海 刘茹太洋 梁娅男 SHAO Guangqiang;PANG Dazhi;ZHANG Jitian;LI Jinglong;WANG Hongxia;LIU Zhihai;LIU Rutaiyang;LIANG Yanan(Department of Thoracic Surgery,The University of Hong Kong-Shenzhen Hospital,Shenzhen,518040,Guangdong,P.R.China;Department of Respiratory Medicine,The University of Hong Kong-Shenzhen Hospital,Shenzhen,518040,Guangdong,P.R.China)

机构地区：[1]香港大学深圳医院胸外科,广东深圳518040 [2]香港大学深圳医院呼吸内科,广东深圳518040

出　　处：《中国胸心血管外科临床杂志》2022年第3期306-310,共5页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

基　　金：深圳医疗卫生“三名工程”(SZSM202011002)。

摘　　要：目的探讨超微5 mm单孔胸腔镜交感神经链切断术在原发性手汗症手术中的临床效果。方法回顾性分析2018年3月1日—2021年2月1日于香港大学深圳医院胸外科就诊并且行超微5 mm单孔胸腔镜交感神经链切断术的90例原发性手汗症患者的临床资料,其中男47例、女43例,年龄26.0(22.0,31.0)岁,术中选择乳晕旁或者腋下5 mm单孔切口行T3和/或T4胸交感神经链切断。结果所有患者均顺利完成手术,术中未出现大出血,无中转开胸病例。围手术期无死亡或者严重并发症病例。手术时间43.0(23.0,60.0)min,术中出血量2.0(1.0,2.0)mL。围手术期仅有1例患者需要留置细胸腔引流管。术后手部多汗症状均消失。术后当天疼痛评分为2.0(2.0,2.0)分。手术后住院时间1.0(1.0,1.0)d。术后1个月所有患者的手汗情况均较手术前明显缓解,手术切口均愈合良好,伤口隐蔽,无伤口感染或者愈合不良,患者对手术切口满意度100.0%。术后出现轻度代偿性多汗患者14例(15.6%),中度代偿性多汗患者5例(5.6%),无重度代偿性多汗患者。综合满意度94.0%。结论超微5 mm单孔胸腔镜交感神经链切断术在原发性手汗症患者中的应用是安全可行的,手术创口极其微小隐蔽,手术时间短,疼痛轻,临床效果良好,能够充分满足患者对微创手术及美学的追求。Objective To assess the feasibility and safety of ultra-micro 5 mm single-port endoscopic thoracic sympathicotomy in selected patients with primary palmar hyperhidrosis. Methods From March 1, 2018 to February 1,2021, 90 patients with primary palmar hyperhidrosis who underwent ultra-micro 5 mm single-port endoscopic thoracic sympathicotomy at the Thoracic Surgery Department of the University of Hong Kong-Shenzhen Hospital. There were 47 males and 43 females, with a median age of 26.0(22.0, 31.0) years. During the operation, T3 and/or T4 thoracic sympathetic nerve chain was transected using an ultra-micro 5 mm single-port incision near the areola or under the axilla.The surgical data of the patients were retrospectively reviewed and analyzed. Results All patients successfully completed the operation without major bleeding during the operation and no conversion to thoracotomy. There was no death or serious complication during the perioperative period. The operation time was 43.0(23.0, 60.0) min, and the intraoperative blood loss was 2.0(1.0, 2.0) mL. In the perioperative period, only one patient needed a tiny chest tube indwelling. The symptoms of hyperhidrosis on the hands all disappeared after the operation. The pain score on the postoperative day was2.0(2.0, 2.0) points. The hospital stay after surgery was 1.0(1.0, 1.0) d. In the first month after the operation, the symptoms of hyperhidrosis on the hands were significantly relieved compared with those before the operation. The surgical incisions healed well, the wounds were concealed, and there was no wound infection or poor healing. The patients’ satisfaction with the surgical incisions was 100.0%. After the operation, 14(15.6%) patients had mild compensatory hyperhidrosis, 5(5.6%) patients had moderate compensatory hyperhidrosis, and no patient had severe compensatory hyperhidrosis. Overall satisfaction rate was 94.0%. Conclusion The clinical application of ultra-micro 5 mm single-port endoscopic thoracic sympathicotomy in selected patients with primary palma

关 键 词：超微5mm单孔 胸腔镜交感神经链切断术 原发性手汗症 

分 类 号：R655[医药卫生—外科学]