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目的探讨单孔胸腔镜下胸交感神经链切断术治疗手-足汗症的临床效果。方法收集2009年1月-2011年1月在单孔胸腔镜下行胸交感神经链切断术治疗手-足汗症30例,手足多汗合并腋下多汗行T2~4切断术22例(A组),未合并腋下多汗而行T2~3切断术8例(B组),并对两组病例进行临床分析。结果 30例单孔胸腔镜下手术均获成功,术后手汗及腋下多汗均消失,足底无汗者24例,足底多汗减少者5例,足底多汗增多者1例。两组病例术后足底多汗改变差异无统计学意义(P〉0.05)。结论单孔胸腔镜下胸交感神经链切断术治疗手-足汗症疗效满意,创伤更小,恢复快,患者易接受。胸交感神经链切断术后部分患者足底多汗可减轻或消失。切断T2~4与切断T2~3对足汗症的影响无差异。 相似文献
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目的 探讨胸腔镜下不同节段胸交感神经链切断术治疗手汗症的疗效及术后代偿性多汗的发生率.方法 将100例胸腔镜下行胸交感神经链切断术患者按治疗方法不同分为两组,A组46例切断T4,B组54例切断T3~4.比较两组患者疗效、代偿性多汗发生率及手术满意情况.结果 两组手术均较为顺利.两组总有效率比较差异无统计学意义(P>0.05).A组术后代偿性多汗发生率明显低于B组[4.3%(2/46)比20.4% (11/54)],术后满意率高于B组[93.5% (43/46)比79.6%(43/54)],差异均有统计学意义(P<0.05).结论 胸镜下T3~4或T4胸交感神经链切断术是非常有效且安全的治疗手汗症的方法,T4切断术后的代偿性多汗的发生率更低. 相似文献
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原发性手汗病是一种因交感神经兴奋异常升高致使患者手部极易出汗的病症[1],在天气热或紧张状态下,患者手汗明显增多,有时汗多如滴珠状,腋下及双足也会伴随多汗[2]。手汗症给患者日常生活、工作和学习带来了极大的困扰[3],临床上对手汗症的治疗研究日益受重视,对中重度手汗症患者,可采用半坐卧位或侧卧位胸腔镜交感神经切除术来治疗,有微创安全和疗效确切的 相似文献
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山东大学齐鲁医院采用电视胸腔镜下双侧交感神经切断术治疗手汗症,取得良好效果。手汗症是较常见的一种原因不明的功能性局部异常多汗。有多汗症的人手掌大多时候都是湿漉漉的,而长期潮湿的手部常会造成脱皮,有碍观瞻,严重时手掌甚至会出现湿疹、皮肤炎性症状。 相似文献
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目的 探讨120例针型胸腔镜T2~4交感神经干切除术治疗手足多汗症的手术室护理配合经验.方法 回顾120例手足多汗症的针型胸腔镜交感神经干切除术的手术室护理配合,全部病例于全麻下接受针型胸腔镜下T2~4交感神经干切断术,手术中监测手掌温度变化.手术前后采用生活质量指数评分(iQOL)进行疗效的评估.结果 所有手术顺利,术后手掌异常多汗等症状完全消失或明显好转,手术时间短,手术效果明显.结论 针型胸腔镜T2~4交感神经干切除术治疗手足多汗症安全、有效,手术室护理配合有助于手术顺利完成. 相似文献
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目的探讨胸腔镜下行双侧胸交感神经切断术的手术配合。方法本组59例病人全部采用全麻双腔气管内插管,取侧卧位,于腋中线第4~5肋间作切口放入10mm挫卡,再于腋前线第2~3肋间作切口放入5mm挫卡,用电钩切断T2、T3交感神经,在切断术侧交感神经干前后,测量同侧手掌皮肤温度。结果59例病人均在胸腔镜下顺利完成手术,术中无并发症发生,术后手汗症状立即消失,手部皮温上升了1.4~2.5℃,且双手干燥。59例患者术后采取门诊或电话随访,失访5例,54例随访16~30个月,平均18.0个月,术后手及腋窝多汗症状均消失,无一例复发。结论胸腔镜下行双侧胸交感神经切断术疗效确切,创伤小,术前充分的准备,术中熟练、默契的配合可使手术顺利完成。 相似文献
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目的探讨应用迷你腔镜和器械以及“二孔法”技术行交感神经切断治疗手汗症的可行性。方法于腋前线第4肋间和第2肋间分别做5 mm与3 mm微小切口,分别入3 mm或5mm迷你腔镜和2.5 mm勾状电极,行胸2交感神经链切断术治疗手汗症31例,不留置胸腔引流。结果手术全部成功,无术后出血、伤口感染等并发症,不用止痛剂,手术伤口少且细微。每侧平均手术时间(25±8)min。术后93.5%(29/31)患者手汗完全消失,1例双手汗减少,另1例一侧手汗完全消失,一侧减少。结论应用迷你腔镜器械和“二孔法”技术行胸交感神经切断治疗手汗症安全、可行、有效,而且美容效果显著。 相似文献
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目的 总结胸腔镜下T3~4交感神经链切断术治疗原发性手汗症的临床经验.方法 回顾性分析胸腔镜下T3~4交感神经链切断术治疗80例原发性手汗症患者的临床资料.结果 80例患者手术均获成功,术后手掌多汗症状立即消失,手术时间(42.5±15.7) min,住院时间(3.9±0.6)d.无霍纳综合征及死亡病例.62例患者随访6~24个月,发生轻度代偿性多汗26例,均无复发.结论 胸腔镜下T3~4交感神经链切断术是治疗原发性手汗症的一种安全、有效的微创治疗方法. 相似文献
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PATIENTS AND METHOD: Thoracic sympathectomy using thoracoscopy was performed in 38 cases on 35 patients from January 01. 1996, till December 31. 2000. In 3 cases bilateral sympathectomy was carried out. The youngest patient was 18, the oldest was 76 years old, the average age was 42 years. The indications for surgery were Raynaud syndrome, causalgia, post-traumatic sympathetic dystrophy, thoracic outlet syndrome combined with vasospastic syndrome, Buerger syndrome, obliteration of digital arteries, embolism and hyperhidrosis. This method was chosen if conservative therapy was unsuccessful. Laparoscopic instruments are particularly suitable for minimal invasive interventions. RESULTS: Authors describe their operative technique whereby the postoperative pain and also the duration of hospitalisation can be reduced, and the cosmetic result can be improved. In two cases conversion was the only choice due to pleural adhesions. Pneumothorax occurred in two cases, haemothorax in one case and transient intercostal neuralgy was seen in 3 cases. In four cases sympathetic activity returned during the follow up. Ceasing the sympathetic innervation dilates the arterioles of the skin, and the temperature of the skin increases. During follow-up the complaints of the patients improved significantly, the progression became slower and clear improvement was found with instrumental investigations. CONCLUSION: This method can be recommended to every institute where the conditions for traditional laparoscopic surgery are given and staff is experienced in thoracotomy. 相似文献
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Objective: We estimated the reliability and validity of the Illness Intrusiveness Ratings Scale (IIRS) in hyperhidrosis, using an electronic mail form of administration. Methods: Recent contributors to an electronic mail discussion group on hyperhidrosis responded to the IIRS, questions about surgical history, items designed to assess severity, and demographic questions, on two occasions four weeks apart. A variety of hypotheses regarding the relationships between these variables were constructed a priori. Results: Sixty-eight people replied on two occasions. Internal consistency was high (Cronbach's 0.88), as was test–retest reliability ( 0.89). The total IIRS score correlated with a global severity question (0.61; p<0.001). Total IIRS score was lower in participants who had previously had surgery for hyperhidrosis, compared with those who had not (47 vs. 36; p=0.02), and changed dramatically in the direction of diminished severity in four patients who underwent surgery during the course of the study (54 vs. 17; p=0.01). Weak-to-moderate correlations were observed between total score and use of topical preparations, use of medications, number of clothing changes during a day, and limitations in choice of wardrobe. Conclusions: The IIRS is both reliable and valid in the assessment of patients with hyperhidrosis. A novel form of administration does not appear to affect its properties. 相似文献
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Malmivaara A Kuukasjärvi P Autti-Ramo I Kovanen N Mäkelä M 《International journal of technology assessment in health care》2007,23(1):54-62
OBJECTIVES: Despite controversies, endoscopic thoracic sympathectomy (ETS) has been used as a treatment for excessive sweating of hands and face and for facial blushing. This study aims to evaluate the effectiveness of ETS for the current indications in a systematic review. METHODS: Controlled clinical trials and cohort studies with more than 100 patients were included. Abstracts were searched from MEDLINE and CCTR from 1966 to June 2004. Two reviewers extracted the data and assessed study quality. Data on effectiveness and safety were synthesized qualitatively. RESULTS: We did not find any controlled clinical trials. Fifteen prospective studies were included. The internal and external quality of these studies were poor overall. Follow-up was commonly less than 2 years, during which time excessive sweating and facial blushing seemed to decrease among most patients. Immediate complications related to thoracoscopy occurred in up to 10 percent of patients. Compensatory sweating below breast level was reported in up to 90 percent of the patients. Other common side effects included dryness of face and hands, gustatory sweating, and neuralgic pain. Several other less common side effects were reported. CONCLUSIONS: The evidence of the effectiveness of ETS is weak due to a lack of randomized trials. The intervention leads to severe immediate complications in some of the patients, and to persistent side-effects for many of the patients. 相似文献
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胸腔镜辅助改良Nuss手术治疗49例小儿漏斗胸临床分析 总被引:2,自引:2,他引:0
目的 总结胸腔镜辅助改良Nuss手术矫治小儿漏斗胸的治疗经验.方法 采用胸腔镜辅助改良Nuss手术矫治49例漏斗胸患者,年龄3~18岁,平均年龄(8.9±4.6)岁.36例畸形为对称型,13例为非对称型.结果 49例患者手术过程顺利,除1例应用2根支撑钢板外,其余48例均只用1根支撑钢板.术中未发生心脏穿通伤等重大并发症,1例早期并发气胸,平均出血量少于10 ml.术后住院时间6~8 d,所有患者均未输血,胸廓畸形矫正满意.矫形效果43例为优,6例为良.全部患者随访时间0.5~23.0个月,钢板无移位,1例术后间歇疼痛2个月,1例术后23个月取出钢板矫形保持优良.结论 改良Nuss手术操作简捷,创伤小,胸廓塑形满意.胸腔镜辅助监视可提高手术的安全性. 相似文献