单腔气管插管麻醉胸腔镜下单孔法同期切断双侧胸交感神经链两种不同术式治疗手汗症术后并发症的比较

Postoperative Complications Comparison of Two Different Surgical Treatments of Cutting off the Bilateral Thoracic Sympathetic Chain at the Same Time by Single-hole Method under Thoracoscope with Single Lumen Endotracheal Intubation Anesthesia in the Treatm

目的:利用单腔气管插管麻醉进行胸腔镜下单孔法同期切断双侧胸交感神经链T4单处与T3、T4双处两种术式,通过对比,探讨两种术式的安全性。方法:选择笔者所在医院2013年1月-2014年1月收治的原发性手汗症患者36例为研究对象,应用单腔管麻醉胸腔镜下施行同期切断双侧胸交感神经链两种不同术式(T4单处及T3、T4双处切断),观察并对比其术后并发症的发生情况。结果:36例均在单腔气管插管麻醉胸腔镜下完成单孔手术,术后手掌多汗症状消失,术后无严重并发症。T4切断组患者代偿性多汗发生率明显优于T3、T4切断组,差异有统计学意义(P<0.05)。结论:单腔气管插管麻醉胸腔镜下单孔法同期切断双侧胸交感神经链T4或T3、T4均为安全术式。而T4胸交感神经链切断并发症更少,更安全。

Objective：To explore the security of two different surgical treatments of cutting off the bilateral thoracic sympathetic chain T4 shall only and T3,T4 double by single-hole method under thoracoscope with single lumen endotracheal intubation anesthesia.Method：36 patients with primary palmar hyperhidrosis in our hospital from January 2013 to January 2014 were selected as the research objects,applying single cavity tube anesthesia under thoracoscope imposed at the same time to cut off the two different dual lateral thoracic sympathetic chain（T4 shall only and T3,T4 double cut）.The postoperative complications were observed and compared.Result：36 patients were completed in single-hole surgery with single lumen endotracheal intubation anesthesia under thoracoscope.After surgery,the palms sweat symptoms disappeared,there was no serious postoperative complications.The incidence rate of compensatory sweating of the T4 cut off group was better than that of the T3,T4 double cut off group,the difference was statistically significant（P〈0.05）.Conclusion：The two different surgical treatments of cutting off the bilateral thoracic sympathetic chain T4 shall only and T3,T4 double by single-hole method under thoracoscope with single lumen endotracheal intubation anesthesia are safe surgical methods.And T4 thoracic sympathetic chain cut has fewer complications and more secure.