肌萎缩侧索硬化患者肺功能及呼吸肌功能的临床研究

目的研究肌萎缩侧索硬化(ALS)患者肺功能及呼吸肌功能的特点。方法将130例ALS患者按临床起病方式分为球部起病组(36例)和肢体起病组(94例),并与健康对照组(30例)的肺功能进行比较;并比较球部起病组(35例)和肢体起病组(89例)的呼吸肌功能。结果与健康对照组比较,球部起病组及肢体起病组肺活量(VC)、用力肺活量(FVC)、第1 s用力呼气量(FEV1)、最大通气量(MVV)、用力呼气高峰流量(PEF)均显著下降(均P0.01)。球部起病组及肢体起病组FEV1/FVC均值(80%)在正常范围,但球部起病组FEV1/FVC显著低于健康对照组(P0.05)。与肢体起病组比较,球部起病组MVV显著降低(P0.05),其他肺功能指标差异无统计学意义(均P0.05)。与肢体起病组比较,球部起病组最大吸气压(MIP)、最大呼气压(MEP)显著降低(均P0.01),第0.1 s口腔闭合压(P0.1)差异无统计学意义(P0.05)。ALS患者呼吸肌功能异常率(87.90%)显著高于肺功能异常率(52.30%)(χ~2=38.07,P=0.000)。结论 ALS患者肺功能障碍以限制性通气功能障碍为主。球部起病患者呼吸肌功能损害较肢体起病患者更加严重。     

慢性阻塞性肺疾病患者长期家庭氧疗对肺功能及认知功能影响的研究

目的 探讨慢性阻塞性肺疾病(COPD)患者配合长期家庭氧疗(LTOT)对肺功能及认知功能的影响。方法 收集确诊为COPD稳定期的患者,根据随机原则分为试验组(配合LTOT)及对照组(未配合LTOT),两组均给予化痰、平喘等常规处理,试验组在其基础上联合LTOT。6个月、12个月后复查肺功能及认知功能,评估相关变化情况。结果 6个月时试验组肺功能第1 s用力呼气量(FEV1)明显高于对照组(P<0.05),用力肺活量(FVC)及最大呼气峰流速值(PEF)差异均无统计学意义(均P>0.05); 12个月时试验组FEV1、FVC及PEF均明显高于对照组(均P<0.05)。12个月后试验组蒙特利尔认知评估量表(MoCA)评分明显高于对照组(P<0.05)。对两组COPD患者严重程度进行划分,极重度COPD患者通过LTOT治疗可明显减轻认知功能损害(P<0.05);治疗12个月时对两组肺功能及认知功能进行相关性分析,试验组FEV1/FVC与MoCA评分呈正相关(P<0.05)。结论 LTOT可显著改善稳定期COPD患者肺功能损伤及认知功能下降,对极重度COPD...     

肌萎缩侧索硬化症肺通气功能改变与病情程度的相关性

目的:探讨肌萎缩侧索硬化症(ALS)患者病情轻重程度与肺功能受损的关系。方法:测定56例ALS患者的肺通气功能:肺活量(VC)、用力肺活量(FVC)、第1秒用力呼气量(FEV1)、第1秒用力呼气量/全部用力肺活量(FEV1/FVC)、最大通气量(MVV)、用力呼气高峰流量(PEF)并与对照组52名(健康人)进行比较,根据ALS患者病情轻重程度分为轻度患者组、中度患者组、重度患者组、终末患者组,对每位患者临床表现进行Norris评分。对每组Norris评分、肺功能指标进行相关性分析。结果:ALS患者通气功能明显减低(P<0.01,表现为限制性通气障碍。除轻度组患者:FEV1/FVC与Norris评分(r=-0.2718)无相关性外,各组指标与Norris评分均呈正相关(0≥r≤1),ALS患者病情的轻重程度与肺通气功能的改变呈正相关。结论:ALS患者肺功能损害表现为限制性通气障碍。病情的轻、重程度与肺功能下降程度呈正相关。     

脑梗死患者呼吸中枢驱动和呼吸功能的变化

目的 探讨脑梗死患者呼吸功能指标及呼吸中枢驱动力的变化,了解脑梗死对患者呼吸中枢及呼吸功能的影响.方法 对35例脑梗死患者和15名健康对照分别进行血气分析、呼吸中枢驱动(P0.1)和肺功能测定,使用SPSS 10.0 for Windows加以分析处理,两组之间各指标比较采用t检验.两因素之间的相关性分析采用直线相关分析.结果 脑梗死患者血氧分压(mmHg,75.80±4.12,1 mm Hg=0.133 kPa)、血氧饱和度(%,94.97±0.78)和最大口腔吸气压(Pimax,kPa,41076±2.443)明显低于健康对照组(分别为88.68±3.77,96.40±0.48和7.747±0.599,t值分别为-8.310、-5.731、-5.439,均P=0.000).P0.1max和P0.1/每分钟通气量比健康对照组低,差异有统计学意义.P0.1/P0.1max、P0.1/PImax较健康对照组高,且差异有统计学意义.用力肺活量(FVC)、一秒用力呼气容积(FEV1.0)、呼气流速峰值(PEF)亦明显低于健康对照组.经相关分析,最大口腔吸气压与血氧分压、血氧饱和度、肺泡动脉氧压差、P0.1max、P0.1、P0.1/Pimax、P0.1/P0.1max、FVC、FEV1.0、PEF密切相关;最大口腔呼气压与P0.1/Pimax、FVC、FEV1.0、PEF密切相关.结论 脑梗死患者呼吸功能受损,氧合指标降低、吸气及呼气功能均受累、中枢呼吸驱动力降低且中枢呼吸驱动储备下降.     

经颅多普勒在慢性脑供血不足诊断中的价值

目的探究经颅多普勒(TCD)在慢性脑供血不足诊断中的应用价值。方法选取2014-01-2016-01中国平煤神马医疗集团总医院收治的慢性脑供血不足患者96例为观察组,取同时期脑梗死患者84例为脑梗死组,另取同期进行正常体检的健康者51例为对照组。对3组患者行TCD检查,对测量的血液流速,血管狭窄情况进行对比,同时对3组的血管阻力指数(RI)、血管搏动指数(PI)及收缩峰/舒张末流速(Vs/Vd,S/D)进行对比分析。结果对照组血流异常率为7.84%,血管狭窄率为5.88%;脑梗死组分别为79.76%、53.57%,观察组分别为64.58%、15.63%;观察组与脑梗死组的血管阻力指数(RI)、血管搏动指数(PI)及收缩峰/舒张末流速(Vs/Vd,S/D)均显著高于对照组,差异均具有统计学意义(P0.05),同时脑梗死组的血管阻力指数(RI)、血管搏动指数(PI)及收缩峰/舒张末流速(Vs/Vd,S/D)高于观察组,差异具有统计学意义(P0.05)。结论经颅多普勒对慢性脑供血不足患者检查可有效了解脑血管功能状态,对慢性脑供血不足患者的病情诊断及预后评估,具有重要作用。     

惊恐发作与肺功能动力学异常

Petna等人最近的研究提示:惊恐发作者都有亚临床的肺功能受损表现,他们将17例惊恐发作患者与20名健康对照者相比,发现惊恐发作患者的肺功能的动力学参数,即最大呼气率(PEFR或FEFmax)、呼气量达肺活量75%时的气流量(FEF75)、最大中间呼吸量(MMEF指用力呼气,呼出25%～75%的气流量)明显降低。病例组与对照组在静息状态下的肺容积没有明显差别。然而早期有一些报导并没有显示惊恐发作患者有肺功能紊乱,为了验证这些结果,我们对受试者作了肺功能动力学评价实验。方法和材料:入组实验的共有27名惊恐发作患者(20名女性,7名男性),年龄在18～4…     

六分钟步行试验与慢性阻塞性肺疾病患者肺功能的关系★

目的：六分钟步行试验是一种简单易行且目前已被公认的评价受试者心肺功能、运动能力、生活质量最重要的研究方法之一。试验旨在评价其在慢性阻塞性肺疾病患者中应用的价值。 方法:①对象及分组：选择2001-01/2006-12在暨南大学第二临床医学院呼吸内科就诊慢性阻塞性肺疾病患者50例，男34例,女16例,平均年龄(70.1±8.9)岁；另选同一时期呼吸科其他病种患者62例做对照，男30例,女32例，平均年龄(66.5±10.1)岁。两组患者对试验知情同意。②实验过程及评估：两组均进行六分钟步行试验、肺功能检查及MRC呼吸困难评分，并对结果进行t检验、ROC曲线分析、相关性分析和多元逐步回归分析,计算Pearson 相关系数。 结果:两组受试者试验数据全部进入结果分析，实验中无脱落者。①六分钟步行试验结果：与对照组比较，慢性阻塞性肺疾病组步行距离更短，血氧饱和度下降分数更高，差异有显著性（P < 0.05）。②ROC曲线分析和直线相关分析：显示六分钟步行试验中血氧饱和度下降分数比步行距离更能有效反映肺功能状态；且与第1秒钟用力呼气量、第1秒钟用力呼气量/用力肺活量存在相关( P < 0. 01)。③多元逐步回归分析：第1秒钟用力呼气量/用力肺活量是六分钟步行试验最有意义的预测指标。 结论:六分钟步行试验与第1秒钟用力呼气量、第1秒钟用力呼气量/用力肺活量存在良好的相关性，可较好的反映患者的肺功能，并有操作简单、方便实用等特点，可以作为慢性阻塞性肺疾病患者日常肺功能的监测手段。     

重症肌无力患者肺功能改变及其与临床肌无力严重度的相关分析

目的 检测重症肌无力(MG)患者的肺功能改变,探讨其呼吸肌力变化与临床肌无力严重度、肺功能改变的关系. 方法 选取解放军第309医院MG治疗中心自2008年8月至2009年5月收治的Ⅰ型MG患者16例,Ⅱ型50例,选取同期健康体检者30例做为对照,检测并比较呼吸肌力[最大吸气压(PIM)、最大呼气压(PEM)、0.1s口腔闭合压(P0.1)]、和肺功能[肺活量(VC)、最大自主通气量(MVV)、峰流速(PF)、总气道阻力(R5)、中心气道阻力(R20]改变,并对Ⅱ型MG患者的呼吸肌力变化与临床肌无力严重度、MG患者呼吸肌力与肺功能的改变行相关性分析. 结果 与对照组比较,Ⅰ型MG患者MVV、PM降低,R20、R5增高,Ⅱ型MG患者VC、MVV、PF、PIM、PEM降低,R5增高,差异有统计学意义(P<0.05).与Ⅰ型MG患者比较,Ⅱ型MG患者PIM、PEM蹦减少,R5、R20增高,差异有统计学意义(P<0.05);Ⅱ型MG患者的PIM、PEM、MVV、VC与肌无力严重度绝对分数均呈正相关关系(r=0.550,P=0.002;r=0.653,P=0.000;r=0.511,P=0.000;r=0.353,P=0.010);MG患者的PIM、PEM分别与VC、MVV、PF均呈正相关关系(P<0.05),且PEM与PIM之间也呈正相关关系(r=0.650,P=0.000). 结论 Ⅰ型MG患者在疾病早期无明显呼吸肌无力表现时可有呼吸肌力减退和呼吸肌耐受力降低,故MVV、PIM、R20、R5可作为早期诊断MG的敏感指标;Ⅱ型MG患者呼吸阻力的增高和呼吸肌力的受损比Ⅰ型MG更严重.且这种损害伴有肌无力严重度绝对分数的增高;呼吸肌力的减退与肺功能的减退呈一致性.     

体外膈肌起搏联合肺康复训练对脑卒中亚急性期患者肺功能和膈肌功能的影响

目的 探讨体外膈肌起搏联合肺康复训练对脑卒中亚急性期患者肺功能和膈肌功能的影响。方法 选取2021-08—2022-10于南京医科大学附属南京医院诊治的脑卒中亚急性期患者80例,采用随机数字表法分为实验组（40例）和对照组（40例）。实验组采用体外膈肌起搏联合肺康复训练治疗,对照组仅采用肺康复训练治疗。所有患者均治疗3周,比较2组治疗前后肺功能、膈肌功能相关指标。结果 治疗3周后,2组第1秒用力呼气容积（FEV1）[(2.07±0.45)L比（2.63±0.41）L,(2.11±0.47)L比（2.42±0.33）L]、用力肺活量（FVC）[(2.31±0.46)L比（2.77±0.38）L,(2.35±0.39)L(2.56±0.31)L]、FEV1/FVC[(81.41±7.55)%比（89.25±6.43）%,(81.29±6.87)%比（85.12±5.32）%]、峰值呼气流量[（1.81±0.23）L/s比（3.15±0.57）L/s,(1.78±0.44)L/s比（2.54±0.41）L/s]、最大自主通气量[（61.78±7.49）L/min比（78.69±5.69）L/...     

脑血管淀粉样变性相关脑出血的手术疗效分析

目的 探讨脑血管淀粉样变性相关脑出血（CAA-ICH）手术治疗的临床效果。方法 回顾性分析2014年3月～2019年3月手术治疗的33例CAA-ICH的临床资料。结果 33例中,年龄<70岁15例（低龄组）,年龄≥70岁18例（高龄组）。小骨窗手术5例,标准骨瓣开颅手术28例（骨瓣回置20例,去骨瓣减压8例）。术后24 h复查头部CT显示血肿清除率在60～95%,平均（80.5±4.2）%。低龄组血肿清除率[（81.6±4.3）%]与高龄组[（79.4±5.1）%]无统计学差异（P>0.05）。低龄组术后发生再出血发生率（6.67%）、肺部感染发生率（40.00%）、下肢静脉血栓发生率（13.33%）与高龄组（分别为11.11%、55.56%、33.33%）无统计学差异（P>0.05）。术后随访1年,按GOS评分：死亡5例,植物生存5例,重残9例,中残10例,恢复良好4例。低龄组预后良好率（60.00%;GOS评分4～5分）明显高于高龄组（27.78%;P<0.05）。结论 CAA-ICH术后并发症发生率高,总体预后不理想。相对年轻的CAA-ICH病人,显微手术...     

Relationships between spinal deformities and respiratory function in patients with severe motor and intellectual disabilities syndrome

The term severe motor and intellectual disabilities syndrome (SMIDS) refers to describe a heterogeneous group of disorders with severe physical disabilities and profound mental retardation. Many patients with SMIDS have spinal deformities such as spinal rotation and scoliosis. On the other hand, they often have respiratory dysfunction, resulting in high mortality from respiratory failure. Therefore, we hypothesized that spinal abnormalities might affect respiratory dysfunction, and analyzed the correlation between spinal abnormalities (Cobb angles (CA) and spinal rotation scores (SRS)) and respiratory parameters (observed during tidal breathing at static supine posture) in 10 patients with SMIDS (M: F 2:8, age 29.0 +/- 7.3 years). The patients inability to make effort in spirometry prevented us from evaluating vital capacity and forced expiratory volume. We measured respiratory rate, tidal volume, and expiratory gas during tidal breathing for 10 minutes. There was no patient with the athethotic type of CP. CA and SRS were found to be correlated with each other (r = 0.81, p < 0.01). CA was inversely correlated with tidal volume (both Vt and Vt/Height;r = -0.69, p < 0.05). Both CA and SRS correlated with respiratory rate (r = 0.67 and 0.69, respectively). Moreover, the slope of the regression lines of the VO2-VCO2 plots (V-slope) was correlated with CA (r = 0.86, p < 0.01). Contrary to our expectation, none of the respiratory parameters showed significant correlations with BMI. Moreover, we found no relationship between the spinal deformity (CA or SRS) and BMI. These observations suggest that the spinal abnormalities affect respiratory patterns in a restrictive manner and increase the respiratory change rate during tidal breathing in patients with SMIDS.     

Randomized control trial of effects of a 10-week inspiratory muscle training program on measures of pulmonary function in persons with multiple sclerosis

Pulmonary impairments have long been recognized as major causes of morbidity and mortality in individuals with advanced multiple sclerosis (MS). This study was designed to determine if a 10-week home exercise inspiratory training program in community-dwelling persons with MS improves pulmonary muscle strength and endurance. Forty-six ambulatory individuals with clinically diagnosed MS [Expanded Disability Status Scale (EDSS) 2.0-6.5, intervention group mean = 3.96 and control group mean = 3.36] were randomly assigned to an intervention group that received 10 weeks of inspiratory muscle strength training (IMT) or a nontreatment control group. Twenty-one subjects in the control group and 20 subjects in the intervention group completed the study. The intervention group demonstrated significantly greater improvement than the control group in maximal inspiratory pressure (P < 0.001). When compared to the control group, no significant differences were noted for maximal expiratory pressure or maximal ventilation volume after training in the intervention group. Baseline and postexercise training comparison of secondary pulmonary expiratory outcomes were significant in the intervention group for forced expiratory volume at one second (FEV1) (P = 0.014), forced vital capacity (FVC) (P = 0.041), and midexpiratory flow rate(FEF(25-75%)) (P = 0.011). No significant changes were noted for the control group. Thus, IMT significantly increased inspiratory muscle strength and resulted in generalized improvements in expiratory pulmonary function in persons with MS who have minimal to moderate disability. Future studies are needed that focus on the long-term effects of IMT with increased resistance and the impact it has on increasing pulmonary function and functional performance.     

Sleep-disordered breathing and pulmonary function in obese children and adolescents

ObjectiveObese children have an increased risk of developing obstructive sleep apnea syndrome (OSAS) compared to normal-weight children. In obese children, OSAS is more frequently associated with oxygen desaturations, which might be caused by pulmonary function abnormalities. Our goal was to investigate the association between OSAS and pulmonary function in obese children and adolescents.MethodsThere were 185 children included and distributed in groups based on their obstructive apnea–hypopnea index (151 controls, 20 mild OSAS, and 14 moderate-to-severe OSAS). All subjects underwent polysomnography and pulmonary function testing.ResultsSeveral differences in pulmonary function were observed between groups. Vital capacity (VC) and forced expired volume in 1 s (FEV₁) were significantly decreased in patients with moderate-to-severe OSAS, as were expiratory reserve volume (ERV), total lung capacity, and functional residual capacity (FRC). Correlations between FEV₁, FRC, and ERV with OSAS severity remained significant independent of the degree of adiposity. Correlations between FEV₁/VC and sleep-related respiratory parameters did not persist after correction for adiposity.ConclusionAn association between awake pulmonary function and sleep-related respiratory parameters could be observed in our population of obese children. These results suggest that OSAS severity is correlated with a diminished lung function. However, the level of obesity remains an important confounding factor in both OSAS severity and pulmonary function.     

Influence of thoracoabdominal movement on pulmonary function in patients with Parkinson's disease: comparison with healthy subjects

Patients with Parkinson's disease (PD) may develop pulmonary dysfunction, but the pathogenesis remains unclear. We investigated a correlation between thoracoabdominal movements and pulmonary function in seven patients with PD and 14 healthy controls. We measured vital capacity (VC) and forced vital capacity (FVC) using an autospirometer, and measured chest and abdominal movements using a respiratory inductance plethysmography by fixing transducers on the rib cage and umbilicus. Patients with PD had significantly decreased % VC (90.3 +/- 17.1 vs 105.8 +/- 13.9%), chest movement (271.3 +/- 79.6 vs. 375.2 +/- 126.7% VT) and abdominal movement (217.6 +/- 93.5 vs. 247.4 +/- 100.2% VT) with 100% VT being an average volume of chest and abdomen at rest during measurement of VC. Patients with PD also had significantly decreased % FVC (74.4 +/- 20.6 vs. 97.6 +/- 14.1%), chest movement (246.2 +/- 115.2 vs. 344.5 +/- 126.4% VT) and abdominal movement (160.3 +/- 105.6 vs 207.6 +/- 104.7% VT) with 100% VT being an average volume of chest and abdomen at rest during forced maximal inspiration. Based on the results, we conclude that a reduction of % VC in patients with PD correlated with chest movements, while a reduction of % FVC correlated with abdominal movement in patients with PD.     

呼气末二氧化碳分压水平对慢性阻塞性肺疾病患者中枢驱动和呼吸应答的影响

目的 探讨不同呼气末二氧化碳分压(PETCO2)水平对慢性阻塞性肺疾病(COPD)患者巾枢驱动和呼吸应答的影响.方法 13例稳定期COPD患者和10例健康志愿者常规测定肺通气功能后,采用二氧化碳(CO2)重复呼吸方法 ,增加PETCO2,从45 mm Hg上升至70 mm Hg.连续记录并计算在不同PETCO2水甲时中枢驱动和呼吸应答的各项生理参数.结果 PETCO2达到70mm Hg的实验时间在COPD组为(8.5±1.6)min,正常组为(16.3±3.2)min,差异有统计学意义(P＜0.05).两组的呼吸频牢(RR)均呈线性增加,正常组稍高于COPD组.COPD组潮气量(VT和分钟通气量(VE)在PETCO2=45～55 mm Hg时,呈显著的线性增加,VT山(0.68±0.25)L 上升到(1.04±0.44)L,VE由(10.59±3.36)L/min上升到(20.13±4.52)L/min.在PETCO2=55～70 mm Hg时VT和VE出现平台.正常组VT和VE呈线性增加,高于COPD组.正常组的吸气时间占呼吸周期比值(T1/Ttot)高于COPD组,差异有统计学意义(P＜0.05).COPD组的呼吸困难评分高于正常组,差异有统计学意义(P＜0.05).两组的平均吸气流量(VT/Ti)和膈肌电电压的均方根(RMS)均呈线性增加,COPD组VT/T1在PETCO2=65～70mm Hg时低于正常组,差异有统计学意义(P＜0.05),而不同PETCO2水平时RMS高于正常组,差异有统计学意义(P＜0.05).COPD组VE/RMS呈抛物线样变化,明显低于正常组,差异有统计学意义(P＜0.05).结论在CO2重复呼吸过程中,COPD患者的呼吸应答和中枢驱动在早期表现为线性递增,后期通气量出现平台,通气-中枢耦联显著异常.正常组的呼吸应答和中枢驱动均表现为线性递增,呼吸应答高于COPD组,而中枢驱动低于COPD组.     

The effect of intermittent positive pressure breathing on lung volumes in acute quadriparesis.

Resting tidal volume and vital capacity were measured daily in 5 patients with acute quadriparesis during the first 7 to 10 days of their hospitalisation. On admission, vital capacity was significantly reduced to 26% of the predicted value (p less than 0.001). This increased significantly over the study period to 33% of the predicted value (p less than 0.02). Expiratory flow rates, measured on one occasion during the study period, showed similar decrements. Tidal volume and vital capacity were also measured immediately following administration of intermittent positive pressure breathing (IPPB). Although the lung volume achieved during IPPB was significantly higher than resting values of tidal volume and vital capacity (p less than 0.001), tidal volume returned to baseline values as soon as IPPB was ceased. Vital capacity remained significantly higher than baseline values at this stage (p less than 0.02), although the mean increase in vital capacity immediately following IPPB was only 43 mls. Acute quadriparesis is associated with a severe ventilatory impairment which includes a reduced vital capacity and expiratory flow rates. IPPB has a positive effect on lung volume whilst it is being administered. Immediately following treatment, this effect does not appear to be sustained at a level which would be considered clinically significant.     

Repeated measurements of pulmonary function following spinal cord injury.

Twelve subjects (11 males, 1 female) with complete spinal cord lesion (level of lesion ranging from C4 to T10), with a mean age of 23.5 years participated in pulmonary function testing (PFT). Inspiratory and expiratory flow measurements were made at 2-month intervals from 25 to 351 days post injury. The values were interpolated and extrapolated to common dates to facilitate comparison. The effect of time on pulmonary function was determined by a repeated measures ANOVA. Forced expiratory volume in 1 second (FEV1.0) significantly increased during the course of the study (40%, p < 0.05), but increases in forced vital capacity (FVC) (32.5%) and maximal voluntary ventilation (MVV) (16%) were not statistically significant. Lesion level was found to be correlated (Spearman Product Moment Correlation) with pulmonary function if a single measure was made (r = 0.55 to 0.73), but emerged as a stronger predictor if the average of several repeated PFTs was correlated with lesion level (r = 0.74 to 0.84). In addition, lesion level was not correlated with the amount of improvement attained during the time period studied. We conclude that the time course of recovery of pulmonary function is variable between individuals with spinal cord injuries and can only be weakly predicted by knowledge of the initial value and the lesion level.     

Thoracoscopic sympathectomy for palmarhyperhidrosis: effects on pulmonary function

Palmar hyperhidrosis, probably caused by an over-reactivity of sympathetic nerves passing through the second and the third thoracic sympathetic ganglia (T2 & T3 ganglia), can only be cured by sympathectomy. Such sympathetic denervation may also alter pulmonary function. Previous studies have shown that open sympathectomy can cause significant deterioration in pulmonary function, however, the surgical procedure itself may contribute to the change. Recently thoracoscopic sympathectomy has been developed as a minimally invasive but effective treatment for palmar hyperhidrosis. In order to investigate the effect of sympathectomy, pulmonary function was compared before and four weeks after operation in 20 patients. Forced vital capacity (FVC) (-2.3%), forced expiratory volume in one second (FEV1) (-6.1%), and FEV1/FVC (-4.6%) were all slightly but significantly decreased four weeks after thoracoscopic sympathectomy. Also the instantaneous forced expiratory flow at 75%, 50% and 25% of the FVC (Vmax25, Vmax50, Vmax75) in flow-volume curves were decreased (-1.6%, -8.4%, and -20% respectively). Therefore, thoracoscopic sympathectomy minimises pulmonary restrictive effects but allows subclinical small airway obstructive effects to become more evident.