电视胸腔镜胸交感神经干切断术治疗手汗症临床应用研究

Research on the Clinical Application of Video-assisted Thoracoscopic Sympathectomy in the Treatment of Palmar Hyperhidrosis

目的探讨电视胸腔镜胸交感神经干切断术治疗手汗症的安全性和有效性。方法 18例手汗症患者在双腔气管插管全麻下接受胸腔镜下双侧胸T3-T4交感神经干切断术,术中采用红外线测温仪监测手掌温度的变化。结果全组手术顺利,无手术死亡。术中监测交感神经干切断前后手掌温度平均升高（2.5±0.7）℃,术毕患者手掌多汗症状消失,双手转为干燥温暖,平均手术时间（60.5±25.7）min、术后平均住院（1.9±0.6）d,所有患者术后随访3-24个月,平均（12.7±5.3）个月,无一例复发。结论胸腔镜交感神经干切断术是治疗手汗症安全、微创和有效的方法。

Objective To explore the safety and effectiveness of video-assisted thoracoscopic sympathectomy in the treatment of palmar hyperhidrosis.Methods A total of 18 cases patients were conducted the bilateral thoracoscopic sympathectomy on T3-T4 sympathetic nerve under the double-lumen trachea intubation general anesthesia.During the operation,the temperature changes of palm were monitored by an infrared thermometer.Results The operation was smooth in the group without the death occurred.The temperature of palm averagely increased（2.5 ± 0.7）℃;the hyperhidrosis disappeared and two palms became dry and warm after the operation.The average operation time was（60.5 ± 25.7）minutes and average hospitalization time was（1.9 ± 0.6）days.All patients had follow-up visit for 3 to 24 months,the average time was（12.7 ± 5.3）months without recurrence occurred.Conclusion The video-assisted thoracoscopic sympathectomy in the treatment of palmar hyperhidrosis is safe,minimally invasive and effective.