T3交感神经节位置变异及其与原发性手汗症手术效果的关系  

The anatomical variation of T3 sympathetic ganglion and its relationship with surgical outcomes in primary palmar hyperhidrosis

作　　者：李晓琪 裴国田 翁文翰 刘彦国[1] 黄宇清[2] Li Xiaoqi;Pei Guotian;Weng Wenhan;Liu Yanguo;Huang Yuqing(Department of Thoracic Surgery,Peking University People’s Hospital,Beijing 100044,China;Department of Thoracic Surgery,Beijing Haidian Hospital,Beijing 100080,China)

机构地区：[1]北京大学人民医院胸外科,北京100044 [2]北京市海淀医院胸外科,北京100080

出　　处：《中华胸心血管外科杂志》2022年第5期262-265,共4页Chinese Journal of Thoracic and Cardiovascular Surgery

摘　　要：目的探讨T3交感神经节解剖位置变异,以及该变异与原发性手汗症手术效果的关系。方法前瞻性纳入2017年11月至2018年9月,采用第4肋骨表面(R4)交感神经切断术治疗的86例原发性手汗症患者。手术中应用近红外荧光胸腔镜观察T3交感神经节的解剖位置。术后随访疗效及副作用,分析T3神经节解剖位置变异与疗效的关系。结果82.6%的T3神经节无解剖位置变异,下移变异至第4肋骨表面或第4肋间者占17.4%。术后1个月随访,无变异侧手汗效果:过干2.1%,干燥39.4%,轻度潮湿57.0%,潮湿1.4%;变异侧依次为13.3%,53.3%,33.3%,0。Mann-Whitney U检验两组间差异有统计学意义(P=0.004)。术后1年随访,无变异侧手汗效果依次为:0,36.5%,56.9%,6.6%;变异侧依次为0,33.3%,63.0%,3.7%。Mann-Whitney U检验两组间差异无统计学意义(P=0.869)。结论荧光胸腔镜显示T3交感神经节位置下移变异率为17.4%;T3神经节下移变异者术后早期手掌偏干。Objective To investigate the anatomical variation of the T3 sympathetic ganglia and its relationship with surgical outcomes in primary palmar hyperhidrosis.Methods A total of 86 patients with primary palmar hyperhidrosiswho underwent R4 sympathicotomy from November 2017 to September 2018 were prospectively enrolled.The anatomical variation of T3 sympathetic ganglia was observed by fluorescence thoracoscopy.The therapeutic effect and side effect were followed up after operation.The relationship between T3 anatomical variation and postoperative effect was analyzed.Results 82.6%of T3 ganglion had no anatomic variation,17.4%of T3 ganglion shifted down to the surface of the fourth rib or intercostal space.After 1 month of follow-up,the therapeutic effect was:overly dry 2.1%,dry 39.4%,mild moist 57.0%,moist 1.4%innormalside,and 13.3%,53.3%,33.3%,0 in the variation side respectively.Mann-Whitney U test showed statistically significant difference between the two groups(P=0.004).After 1 year of follow-up,the effect was 0,36.5%,56.9%,6.6%in normal side,and 0,33.3%,63.0%,3.7%in the variation side respectively.There was no significant difference between the two groups by Mann-Whitney U test(P=0.869).Conclusion Fluorescence thoracoscopy showed that the variation rate of the position of T3 sympathetic ganglion was 17.4%.Postoperatively,patients with the downshift variation of T3 sympathetic ganglion have drier hands in short-term follow-up.

关 键 词：原发性手汗症 荧光胸腔镜 交感神经 解剖变异 交感神经切断术 

分 类 号：R655[医药卫生—外科学]