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发生率研究

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.

Clinical effect of endoscopic thoracic sympathectomy at different segments on palmar hyperhidrosis and incidence of postoperative compensatory hyperhidrosis

Objective To study the clinical effect of endoscopic thoracic sympathectomy at different segments on palmar hyperhidrosis and research the incidence of postoperative compensatory hyperhidrosis.Methods One hundred palmar hyperhidrosis patients who underwent endoscopic thoracic sympathectomy were divided into 2 groups according to treatment method,the patients in A group （46 cases） received T4 surgery,the patients in B group （54 cases） received T3-4 surgery.The success rate of postoperative,incidence of postoperative compensatory hyperhidrosis and postoperative satisfaction rate between the 2 groups were compared.Results The surgery of 2 groups were successful.There was no statistical difference in total effective rate between the 2 groups （P 〉 0.05）.The incidence of postoperative compensatory hyperhidrosis in A group was significantly lower than that in B group 4.3% （2/46） vs.20.4% （11/54）],the postoperative satisfaction rate was significantly higher than that in B group 93.5%（43/46） vs.79.6% （43/54）],there were statistical differences （P 〈 0.05）.Conclusion Endoscopic thoracic sympathectomy T3-4 or T4 surgery is very effective and safe treatment of palmar hyperhidrosis,but T4 surgery has a lower incidence of postoperative compensatory hyperhidrosis.