胸腔镜下 T4 交感神经干切断术对原发性手汗症患者生活质量的影响

目的：应用改良生活质量量表评价胸腔镜下T4交感神经干切断术前、术后原发性手汗症患者生活质量的 变化。方法：收集2009年6月至2014年5月接受胸腔镜下双侧T4交感神经干切断术治疗原发性手汗症患者48例。手术 前后患者完成生活质量自评、改良生活质量量表并予以量化评分。术后1，6个月进行随访并收集手术效果、并发 症、满意度、生活质量调查资料。结果：48例患者均顺利完成双侧同期胸腔镜下T4交感神经干切断术，无死亡及严 重并发症，未发生术中中转开胸情况。术后轻度代偿性多汗38例(79.1%)，中度1例(2.1%)，无重度代偿性多汗。47例 (97.9%)对手术效果非常满意，没有不满意以及后悔接受手术治疗病例。48例患者均顺利完成改良的手汗症专用生活 质量量表问卷，生活质量量表评测显示手汗症患者术后生活质量比手术前明显改善(F=763.67，P<0.001)。结论：原发 性手汗症严重影响患者的生活质量。胸腔镜下T4交感神经干切断术不仅明显减少手部出汗量，而且可以明显改善患 者生活质量。

Effect of T4 endoscopic thoracic sympathicotomy on life quality in patients with primary palmar hyperhidrosis

Objective: To assess the quality of life in patients with primary palmar hyperhidrosis before and aft er T4 endoscopic thoracic sympathicotomy (ETS) using the modifi ed rating scales system for life quality. Methods: Between June, 2009 and May, 2014, forty-eight patients with primary palmar hyperhidrosis received ETS at the thoracic level T4. Patients completed self assessment of lifequality by the modified rating scales system before and after the surgery. Follow-up data including effectiveness of operation, patient satisfaction and life quality were obtained at 1 and 6 months after the surgery. Results: ETS at the thoracic level T4 was performed successfully for all cases. No mortality or serious complications were observed. No one needed thoracotomy in the period of surgery. Mild or moderate compensatory sweating was appeared in 38 cases (79.1%) or 1 case (2.1%), respectively. None severe case was observed after T4 ETS. About 97.9% of the patients were very satisfied with the result of the operation and no patient regretted the surgical procedure. All patients answered the quality of life (QoL) questionnaire and showed the improvement of QoL after the procedure (F=763.67, P<0.001). Conclusion: Primary palmar hyperhidrosis led to the reduction of life quality. ETS at T4 level could reduce sweating production and improve QoL in patients with primary palmar hyperhidrosis.