胸腔镜单孔交感神经干T4切除术治疗手汗症临床分析

Clinical analysis of treating palmar hyperhidrosis by thoracoscopic single-holesympathetic trunk T4 resection

目的总结电视胸腔镜单孔胸交感神经切除术治疗手汗症的临床经验。方法分析2008年3月～2010年3月间应用电视胸腔镜行选择性胸交感神经干T4切除术治疗9例手汗症患者的临床资料。结果 9例患者手术全部成功。平均手术时间(双侧)(23.3±4.7)min,平均住院时间(2.5±1.5)d,平均随访时间(20.1±2.3)个月,1例患者出现躯干、大腿和脚等处的代偿性多汗,但患者能够耐受,不需要进一步治疗。结论电视胸腔镜下单孔选择性胸交感神经干(T4)切除术是治疗手汗症的一种疗效确切、创伤小和安全的治疗方法。

Objective To summarize the clinical experience of treating palmar hyperhidrosis by video-assisted thoracoscopic single-holesympathectomy. Methods From March 2008 to December 2010,9 patiens suffering from palmar hyperhidrosis underwent video-assisted thoracoscopic sympathectomy.Their clinical materials were analysed ret rospectively and the literatures were reviewed. Results The selective video-assisted thoracoscopic sympathectomy was successfully performed in all patients.The operation time（both side）was （23.3 ± 4.7）min with an average of 28 min.The median hospital stay was（2.5 ± 1.5）d.The mean follow-up was （20.1 ± 2.3）months.One patient developed compensatory（increased） sweating in the trunk,One patient in the thighs and the feet,but the symptoms were mostly tolerable and required no further treatment. Conclusion Video-assisted thoracoscopic sympathectomy is a safe,effective and minimally invasive therapeutic solution for patients with palmar hyperhidrosis.