不同位置胸交感链切断治疗手汗症与术后代偿性出汗的关系

Relation Between Compensatory Sweating and the Thoracic Sympathectomy in Treatment of Palmar Hyperhidrosis

目的通过研究手汗症治疗中胸交感神经链切断位置与术后代偿性出汗的关系,探讨其并发症发生的可能机制。方法2004年10月至2005年12月我院手术治疗手汗症患者128例,术前随机分成胸3交感神经链组(T3组,61例),胸4交感神经链组(T4组,67例)。两组患者均为全身麻醉,单腔气管内插管经肋间行电视纵隔镜手术。结果两组手术均顺利,无严重并发症发生或围手术期死亡患者。手多汗症状均完全改善,两组间轻度代偿性出汗发生率差异无统计学意义(χ2=1.866,P=0.122),中度代偿性出汗T4组显著低于T3组(χ2=7.618,P=0.006),两组无1例发生重度代偿性出汗。结论降低胸交感神经链切断位置(T4)有利于降低代偿性出汗的发生率和严重程度。

Objective To examine the relation between compensatory sweating（CS） and the resection site of the sympathetic nerve china during sympathectomy in treatment of palmal hyperhidrosis and thus to investigate the potential mechanism of the occurrence of compensatory sweating. Methods From October 2004 to December 2005, 128 patients with primary palmar hyperhidrosis were randomly divided into two groups： 61 with T3 sympathicectomy （T3 group） and 67 with T4 sympathicectomy （T4 group）. All were treated under general anesthesia, single lumen intubation and via intercostal mediastinoscopic surgery. Results No morbidity or mortality occurred. Sweating of target organs was cured in all cases. Rates of minor CS in Group T3 or T4 showed no statistically significant （χ^2 = 1.866, P = 0.122）. Rate of moderate CS in group T4 was significantly lower than that in group T3 （χ^2=7.618, P=0.006）. No severe CS occurred. Conclusion Occurrence rate and severity of compensatory sweating are lower in T4 resection than in T3.