单孔胸腔镜下右侧R_(3)、左侧R_(4)交感神经切断术治疗原发性手汗症的效果  

Effect of Uniportal Thoracoscope Right R_(3) Combined with Left R_(4) Sympathectomy in Treatment of Primary Palmar Hyperhidrosis

作　　者：崔东[1] 陈茂林 张卫东[1] 栾加强 冯雨 侯曼曼 蔡祖勋[1] 钱如林[1] CUI Dong;CHEN Maolin;ZHANG Weidong;LUAN Jiaqiang;FENG Yu;HOU Manman;CAI Zuxun;QIAN Rulin(Department of Thoracic Surgery,Henan Chest Hospital,Zhengzhou 450003,China)

机构地区：[1]河南省胸科医院胸外科,河南郑州450003

出　　处：《河南医学研究》2025年第3期402-405,共4页Henan Medical Research

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20200223)。

摘　　要：目的观察单孔胸腔镜下右侧R_(3)、左侧R_(4)交感神经切断术治疗原发性手汗症的效果和安全性。方法选取2021年10月至2023年6月于河南省胸科医院胸外科行单孔胸腔镜下交感神经切断术的50例中、重度原发性手汗症患者为研究对象,随机分为观察组与对照组,每组25例。观察组行右侧R_(3)、左侧R_(4)交感神经切断术,对照组行双侧R_(3)交感神经切断术。比较两组患者各项临床指标及术后恢复情况。结果两组均在单孔胸腔镜下顺利完成手术,无围手术期死亡和严重并发症。术后观察组10例左手有轻度潮湿,观察组2例、对照组1例双手轻度潮湿,对照组左手潮湿率低于观察组(P<0.05)。观察组14例(56.0%)发生代偿性多汗,对照组18例(72.0%)发生代偿性多汗,两组轻度代偿性多汗发生率差异无统计学意义,观察组中、重度代偿性多汗发生率低于对照组(P<0.05)。结论单孔胸腔镜下右侧R_(3)、左侧R_(4)交感神经切断术治疗原发性手汗症效果确切,又降低了中重度代偿性多汗发生的概率,安全可行,值得进一步探索推广。Objective To observe the efficacy and safety of uniportal thoracoscope right R_(3) combined with left R_(4) sympathectomy in treatment of primary palmar hyperhidrosis.Methods From October 2021 to June 2023,50 patients with moderate or severe primary palmar hyperhidrosis underwent uniportal thoracoscope sympathectomy in the Department of Thoracic Surgery of Henan Chest Hospital were enrolled in the study and randomly assigned into observation group and control group,with 25 cases in each group.Observation group recieved right R_(3) combined with left R_(4) sympathectomy and a control group recieved bilateral R_(3) sympathectomy.The clinical indicators and postoperative recovery were compared between the tow groups.Results All procedures were carried out successfully without severe morbidity or mortality.There were 10 cases of left hand with mild damp in the observation group,2 cases in the observation group and 1 case in the control group.The damp rate of left hand in the control group was lower than that in the observation group(P<0.05).Compensatory hyperhidrosis occurred in 14 cases(56.0%)and 18 cases(72.0%)respectively in observation group and control group.There was no significant difference in the incidence of mild compensatory hyperhidrosis between the two groups.The incidence of moderate and severe compensatory hyperhidrosis in the observation group was lower than that in the control group(P<0.05).Conclusion Uniportal thoracoscope right R_(3) combined with left R_(4) sympathectomy is effective in treatment of primary palmar hyperhidrosis,and reduces the probability of moderate and severe compensatory hyperhidrosis,which is safe and feasible and worthy of further exploration and promotion.

关 键 词：原发性手汗症 胸腔镜 交感神经切断术 代偿性多汗 

分 类 号：R655[医药卫生—外科学]