基于循证医学进行手汗症病人手术方案的制定

The Surgical Strategy for Hyperhidrosis Patients: An Evidence-based Guide

目的通过对10年来国内外手术治疗多汗症随机对照研究的总结,探讨手足多汗症最佳手术方案的选择。方法通过检索中国生物医学文献数据库(CBM),检索关键词"(手汗症OR多汗症)AND对照",检索pubmed数据库检索,检索关键词hyperhidrosis AND("randomized control"OR RCT),纳入10年内国内外交感神经链切断术治疗手足多汗症的随机对照临床试验研究。结果符合纳入标准的中文文献4篇,英文文献5篇,但缺乏多中心、大样本的前瞻性临床随机对照研究,国内大多数研究都限于回顾性或是经验报道。结论 (1)在T2-4之间任何一个节段切断交感神经链均可以治疗多汗症;(2)代偿性多汗是术后最常见的并发症,保留T2是减少代偿性多汗的关键。

Objective To find the best surgical strategy for hyperhidrosis patients through a study of 10 years＇ literature. Methods The Chinese Biological Medicine （CBM） and pubmed database were searched using key words ＂（hyperhidrosis OR palmar hyperhidrosis） AND control＂ and key words ＂hyperhidrosis AND （＂randomized control＂ OR RCT）＂ respectively. And the literatures satisfying the following requirement were chosen： （1） The object of study was hyperhidrosis patients. （2） The study was a randomized control trial. Results Four Chinese and five English literatures were found. But multicenter, large samples and prospective randomized controlled clinical study was notfound. Conclusion （1） The resection of any segment between the T2-4 sympathetic chain can effectively treat hyperhidrosis; （2） Compensatory hyperhidrosis is the most common complication and the T2 level remained denervation is the key to reduce it.