一孔法胸腔镜下交感神经链切断术治疗手汗症30例临床研究

Endoscopic Thoracic Sympathectomy with One Trocar for Palmar Hyperhidrosis：Report of 30 Cases

目的探讨一孔法电视胸腔镜下T3或T4交感神经链及其侧支切断术治疗手汗症的可行性。方法在全麻双腔气管插管下施行T3或T4交感神经链及其侧支切断术治疗手汗症30例。结果30例手术均获成功，术后患者手掌多汗症状消失，有效率为100％，术后掌温升高（2．5±0．8）℃。30例随访1．5-12个月，平均8月，无一例复发及严重代偿性多汗．轻度代偿性多汗1例，占3．3％0／30）。结论一孔法电视胸腔镜下]r3或T4交感神经链及其侧支切断术治疗手汗症疗效确切，创伤小，疼痛较轻，且术后代偿性多汗发生率低，程度轻微，是一种安全、有效的手术方式。

Objective To evaluate the feasibility and efficacy of dissection of T3 or T4 sympathetic nerve and its side branch with one trocar by using thoracoscope for the treatment of primary palmar hyperhidrosis. Method Under general anesthesia with double-lumen Intubation,T3 or T4 sympathectomy was performed on 30 patients by using thoracoscopy.Results The operation was completed successfully in all the 30 patients with the Symptoms of palmar hyperhidrosis disappeared and the skin temperature increased by a mean of （2.5 - 0.8）℃. All the patients＇ follow-up was achieved for 1.5 tO 12 months（mean,8 months）.During the period,no recurrence or severe compensatory hyperhidrosis occurred;one patient showed mild compensatory hyperhidrosis accounting for 3.3% of the 30 cases（1/30）.Conclusion Endoscopic thoracic T3 or T4 sympathectomy with one trocar is a safe,effective,and minimally invasive procedure for palmar hyperhidrosis.