胸腔镜下交感神经切断术治疗雷诺综合征新进展

Endoscopic thoracic sympathectomy for Raynaud Syndrome

雷诺综合征是一种发作性肢端缺血性疾病，典型症状为受寒冷或情绪变化等刺激时肢端皮肤依次出现苍白、紫绀和潮红“三相”颜色变化。目前发病机制尚未完全明确，也无有效根治方法。近年来胸腔镜下交感神经切断术逐渐应用于雷诺综合征的治疗，术后起效快，短期效果良好，与其他手术相比难度小、风险低，但仍存在高复发率的缺点。目前缺少不同术式之间的大样本临床对照试验，仍需进一步改良术式及明确术后评估标准。本文对胸腔镜下交感神经切断术治疗雷诺综合征的进展作一综述。

Raynaud Syndrome（RS） is a kind of paroxysmal digital ischemic disease whose typical symptom is character- istic tricolor change featuring pallor, cyanosis, and erythema induced by cold or emotion changing. The pathogenesis of RS is still not entirely clear, and there is no radical treatment. In recent years, endoscopic thoracic sympathectomy （ETS） for Raynaud Syndrome is gradually applied. ETS produces a high rate of initial relief, and has lower risk and technical difficulty compared with other surgical options, while its poor long-term outcome can＇ t be ignored. There is currently a lack of a large number of clinical controlled trials between different operations, and there is still a need for further improved surgical procedures and accurate postoperative evaluation criteria. In this review, the recent advances of ETS is summarized.