77例手-脚汗症经电视胸腔镜胸交感神经切断术的疗效分析

The effect of endoscopic thoracic sympathectomy of 77 cases with palma-plantar hyperhidrosis

目的 探讨用电视胸腔镜外科技术治疗手-脚汗症的效果.方法 2006年1月至2009年1月经电视胸腔镜手术治疗手-脚汗症77例,其中因合并腋下多汗而行T2～T4切断术52例（A组）,未合并腋下多汗而行T2～T3切断术25例（B组）.结果 术后手汗及腋下多汗均消失,脚底无汗者7例,脚底多汗减少者34例,脚底多汗无明显变化者32例,脚底多汗增多者4例.A组与B组术后脚底多汗改变差异无统计学意义（P＞0.05）.结论 每侧单孔电视胸腔镜手术治疗手-脚汗症创伤更小,患者更易于接受.胸交感神经切断术后部分患者脚底多汗可减轻或消失.切断T2～T4与切断T2～T3对脚汗症的影响无差别.

Objective To analyse the effect of endoscopic thoracic sympathectomy of palma-plantar hyperhidrosis. Methods Between January 2006 and January 2009,77 cases with palma-plantar hyperhidrosis were operated by thoracoscope. Fifty-two cases of palma-axillary-plantar hyperhidrosis were performed sympathectomy of T2-T4 and 25 cases of palma-plantar were performed sympathectomy of T2-T3.Bilateral procedures were completed in the same position. Results After operation palmar hyperhidrosis and armpits hyperhidrosis all were cured. Of soles, 7 cases were completely dry, 34 cases nearly dry, 32 cases unchanged and 4 cases worse. There was no significant difference in the change of plantar hyperhidrosis between sympathectomy of T2-T3 and T2-T4 （P 〉 0.05）. Conclusions Bilateral single port for endoscopic thoracic sympathectomy produces slighter trauma and patients easily accept it. Plantar sweating can be relieved or nearly relieved in partial patients after thoracic sympathectomy. There is no difference in the effect of plantar hyperhidrosis between sympathectomy of T2-T3 and T2-T4.