交感神经节切除术治疗雷诺病

目的：研究胸腔镜交感神经节切除术或化学性腰交感神经节切除术治疗雷诺病。方法：本组5例，男性1例，女性4例，年龄30－65岁（平均43．5岁）。雷人表现在手部者1例，只表现在足部并伴有1足趾坏疽者1例，其余3例四肢均受影响。对有手部症状者行胸腔镜交感神经节切除术，而对足部症状者行化学性腰L2－3交感神经节切除术。结果：5例随诊2－48个月（平均24个月），有手部症状者均于术后立即得到改善，双手温暖，效果满意。但6个月后有2例原有症状均复发。化学性腰交感神经切除术后者，双足温暖，一直未复发，效果满意。结论：胸腔镜交感神经节切除术治疗手部雷诺病获得短期缓解，但效果不甚理想。化学性腰交感神经节切除术对雷诺病有显著效果，症状消失不再复发。

Treatment of Raynaud disease by sympathectomy

Objective To study the effect of thoracoscopic sympathectomy or chemical lumbar sympathectomy on patients with Raynaud disease . Methods A total of 5 patients were analyzed, 1 male and 4 female age 30-65 (mean 45.30) . Raynaud phenomenon appeared only on both hands in one case, only on feet with a toe gangrene in another one, the other 3 cases on all limbs. Thoracoscopic sympathectomy was performed in those affecting hands and chemical lumbar sympathectomy of L2-3 in those affecting feet. Results All patients were foEowed up for 12 to 48 months (mean 24 months). After operation the hands became warm and with satisfactory results However, the original symptoms recurred in two cases 6 months after operation. All 4 patients received chemical lumbar sympathectomy, feet became wanned and with satisfactory results and the symptoms did not recur up to now. Conclusion Thoracoscopic sympathectomy for hands affected by Raynaud disease has temporary efficiency but is not satisfactory. The chemical lumbar sympathectomy for the feet affected by Raynaud disease has dramatic effect on symptoms and results are very good.