胸腔镜下不同节段交感神经干切断术治疗手汗症的随机自身对照研究

目的探讨胸腔镜下不同节段胸交感神经切断术治疗手汗症的疗效和术后代偿性多汗的差异。方法对56例手汗症患者行胸腔镜下胸交感神经链切断术,术前随机决定左右两侧交感神经不同切断节段的位置(T3或T4),术后评定疗效并进行随访。结果两组均获成功,术后手掌多汗症状全部消失,术后无严重并发症。轻-中度代偿性多汗发生率分别为39.3%(T3)和19.6%(T4),差异有统计学意义(χ2=4.76,P0.05),无重度代偿性多汗。结论降低胸交感神经链切断位置(T4)有利于降低代偿性多汗的发生率。

Randomized and self-controlled study of palmar hyperhidrosis treated by sympathectomy at different segments under thoracoscope

Objective To observe the curative effects and post-operative compensatory hyperhidrosis of sympathectomy at different segments for palmar hyperhidrosis under thoracoscope.Methods Fifty-six patients with palmar hyperhidrosis were performed with sympathectomy under thoracoscope. Position of the sympathectomy of two sides（T3 or T4） was randomly decided before operation. Results Operation was successfully performed on all patients, and their palmar hyperhidrosis was completely alleviated after operation. No surgery-related post-operative complication occurred. The incidence of light-moderate compensatory hyperhidrosis was 39.3% in T3 group, and 19.6% in T4 group（χ2=4.76, P＜0.05）,and no severe compensatory hyperhidrosis was recorded. Conclusions Occurrence rate of compensatory hyperhidrosis is lower in T4 resection than in T3.