微创交感神经链切断术治疗手汗症20例临床分析

目的:总结胸腔镜下微创交感神经链切断治疗手汗症的经验。方法:手汗症患者20例在静脉复合麻醉下行双腔气管插管5例,行单腔气管插管15例。分别于左、右胸壁第5和第3肋间分别作2个5mm的切口,置入5mm 30°观察镜和电钩,分别在两侧第2、3肋和第4肋水平切断交感神经链。结果:所有患者手汗和腋汗全部消失,足汗患者17例中足汗完全消失15例,术后住院2~3天,平均2.5天。无手术死亡和严重并发症。结论:胸腔镜微创交感神经链切断术治疗手汗症操作简单,患者恢复快。手术成功的关键是准确的神经节定位。

Minimally invasive of thoracospic sympathectomy for hyperhidrosis

Objective:To sum up the experience in using minimal invasion of thoracospic sympathectomy for hyperhidrosis.Methods:Of the 15 hyperhidrosis patients who received combined intravenous anesthesia,5 were given double-lumen endotracheal intubation,and 10 were given single-lumen endotracheal intubation,and 10 were given single-lumen endotracheal intubation.Two 5mm incisions were individually made in the fifth and third rib spaces on each side of the chest wall,a 30-degree 5mm edoscope and a cautery hook were put in,and sympathetic ganglia at T2,T3 and T4 were respectively cut off.Results:Palmar and axillary hyperhidrosis disappeared in all the 15 patients,and plantar hyperhidrosis vanished in 10 of the 12 patients,with a successful rate of 100 per cent and 83per cent,respectively.The post operative hospital stay lasted only for two or three days,with an average of 2.5 days.There was no death,and no serious complications,too.Conclusion:(1) The operation of minimal invasion by thoracoscope is simple,and patients have a good recovery.(2) The key of success is such an operation is to locate the sympathetic ganglia correctly.(3) The use of minimal invasion of sympathectomy for hyperhidrosis makes operation simplified,and reduces the operative wound.(4) We may cut T2 and T3 for palmar hyperhidrosis,and cut T4 for axillary hyperhidrosis.