电视胸腔镜下的手汗症外科微创治疗

Video-assisted thoracoscopy in treatment of palmar hyperhidrosis

目的探讨胸腔镜下切断胸交感神经链治疗原发性手汗症的有效性与安全性。方法对56例手汗症患者行胸腔镜下胸交感神经链切断术。术中实时监测手掌皮肤温度,以温度变化决定交感神经链的切断范围。结果术后患者手汗症状全部消失（100%）,手掌温度上升1.4℃~3.8℃,16例（100%）并腋汗增多者症状全部消失;并足汗增多者40例中,消失30例（75%）,减轻10例（25%）。术后有5例出现少量气胸,1例血胸;未出现代偿性多汗及霍纳征等严重术后并发症。结论胸腔镜下切断胸交感神经链治疗原发性手汗症是一种创伤性小、有效率高、安全性好的理想手术方式。

Objective To explore the validity and safety of video-assisted thoracoscopic sympathectomy in treatment of primary palmar hyperhidrosis. Methods 56 cases with primary palmar hyperhidrosis admitted our hospital from January 2008 to December 2012 underwent vide-assisted thoracoscopic sympathectomy.Results After the operation,the symptom of palmar hyperhidrosis was completely alleviated and the temperature of palm rase by 1. 4 ~ 3. 8℃. The armpit hyperhidrosis vanished in 16 cases（ 100%）,foot hyperhidrosis disappeared in 30 cases of 40 cases（ 75%） and alleviated in 10 cases（ 25%）. Five cases appeared minor pneumothorax,and I case had hemothorax. There were no serious postoperative complications such as compensatory hyperhidrosis and Horner’ s syndrome. Conclusion Video-assisted thoracoscopic sympathectomy is a minimally invasive,effective and safe procedure for primary palmar hyperhidrosis.