胸交感神经链射频消融术与无水乙醇注射治疗原发性头、手多汗症的临床疗效比较  

Comparing efficacy between thoracic sympathetic chain radiofrequency ablation and anhydrous ethanol injection on primary hyperhidrosis in the head and palms

作　　者：何建国 黄婷 黄冰 冯智英 He Jianguo;Huang Ting;Huang Bing;Feng Zhiying(Department of Painology,Li Huili Hospital of Ningbo Medical Center,Ningbo City,Zhejiang Province 315100,China;Department of Painology,Ningbo Rehabilitation Hospital,Ningbo City,Zhejiang Province 315000,China;Department of Painology,Jiaxing First People's Hospital,Jiaxing City,Zhejiang Province 314001,China;Department of Painology,The First Affiliated Hospital of Zhejiang University,Hangzhou City,Zhejiang Province 310003,China)

机构地区：[1]宁波市医疗中心李惠利医院疼痛科,宁波市315100 [2]宁波市康复医院疼痛科,宁波市315000 [3]嘉兴市第一人民医院疼痛科,浙江省嘉兴市314001 [4]浙江大学附属第一医院疼痛科,杭州市310003

出　　处：《中华疼痛学杂志》2023年第3期464-469,共6页Chinese Journal Of Painology

基　　金：2019年浙江省医药卫生项目(2019KY629)。

摘　　要：目的观察CT引导下胸交感神经链无水乙醇与射频消融术治疗原发性头、手多汗症的临床疗效,比较两种治疗方式的差异。方法收集2017年6月至2021年12月宁波市康复医院疼痛科入院治疗的60例原发性手、头多汗症患者作为研究对象,随机分为无水乙醇组和射频消融组,每组30例。所有患者均于CT引导下进行治疗,头部多汗者选择T3交感神经链治疗,手部多汗者采用T4交感神经链治疗,无水乙醇组和射频消融组分别给予无水乙醇和射频消融术治疗。记录比较两组患者的有效率、满意度、手术时间、住院日数、总费用、48 h内PI值、手部温度、术后并发症发生情况。结果无水乙醇组手术时间、住院日数均较射频组长(P<0.05);满意度、住院费用无水乙醇组均低于射频组(P<0.05);术后24 h无水乙醇组疼痛评分低于射频消融组(P<0.05)。术后12、24及48 h干燥程度比较,射频组明显较无水乙醇组干燥,两组差异有统计学意义(P<0.05);术后并发症发生率无水乙醇组明显高于射频消融组(P<0.05)。结论CT引导下胸交感神经链射频消融术与无水乙醇注射均能有效治疗原发性头、手多汗症,但前者的综合疗效优于后者。Objective To compare the clinical efficacy of CT-guided thoracic sympathetic chain ethanol(EtOH)alcohol injection or radiofrequency ablation(RFA)in the treatment of primary hyperhidrosis.Methods Sixty patients with hyperhidrosis of heads and palms,hospitalized from June 2017 to December 2021 in the Department of Painology,Ningbo Rehabilitation Hospital,were randomly divided into EtOH group and RAF group with 30 patients in each group.Patients were treated by ethanol alcohol injection in EtOH group or radiofrequency ablation in RAF group under CT-guided at T3 sympathetic ganglion for the craniofacial hyperhidrosis,at T4 sympathetic ganglion for the palmar hyperhidrosis.The effective rate,satisfaction,general data,operation time,hospitalization days,total cost,PI value within 48 hours,hand temperature and postoperative complications were compared between the two groups.Results The operation time and hospitalization days were longer in the EtOH group than those in the RAF group(P<0.05);the satisfaction and hospitalization cost were lower in the EtOH group than those in the RAF group(P<0.05);the pain score was lower in the EtOH group at 24 hours after operation than those in the RAF group(P<0.05).The patients were significantly drier in the RAF group than that in the EtOH group at 12,24 and 48 hours after the operation(P<0.05).Postoperative complications were significantly lower in the RAF group than those in the EtOH group(P<0.05).Conclusion CT-guided thoracic sympathetic chain ethanol alcohol injection and radiofrequency ablation were both effective in the treatment of primary hyperhidrosis,but radiofrequency ablation is better than EtOH injection.

关 键 词：多汗症 射频消融术 胸交感神经链 无水乙醇 

分 类 号：R758.743[医药卫生—皮肤病学与性病学]