人工气胸辅助非气管插管麻醉下行胸腔镜胸交感神经切除术治疗原发性手汗症的效果

Effect of thoracoscopic thoracic sympathectomy with artificial pneumothorax and non tracheal intubation anesthesia in the treatment of primary palmar hyperhidrosis

目的探讨人工气胸辅助非气管插管麻醉下行胸腔镜胸交感神经切除术治疗原发性手汗症的临床效果。方法抽取2019年1月至2019年12月于河南省胸科医院行胸腔镜下胸交感神经切断术的72例原发性手汗症患者为研究对象,按随机数字表法将其分为研究组与对照组,每组36例。研究组行保留自主呼吸的非气管插管下静脉复合麻醉,术中在人工气胸辅助下行胸交感神经切除术,对照组在双腔气管插管静脉复合麻醉下行胸交感神经切除术。比较两组患者各项临床指标。结果两组患者手术时间、术后代偿性多汗发生率比较,差异未见统计学意义(P>0.05)。研究组术前麻醉时间、术后复苏时间、视觉模拟评分法评分、住院时间均少于对照组(P均<0.05),术后刺激性咳嗽、咽喉部不适发生率低于对照组(P<0.05)。结论人工气胸辅助非气管插管下行胸腔镜胸交感神经切断术治疗原发性手汗症安全可行。

Objective To investigate the clinical effect of artificial pneumothorax assisted thoracic sympathectomy under thoracoscope in the treatment of primary palmar hyperhidrosis.Methods Seventy-two patients with primary hand hidrosis who underwent thoracoscopic sympathetic neurotomy in Henan Provincial Chest Hospital from January 2019 to December 2019 were selected as the research subjects,and they were divided into study group and control group according to random number table method,with 36 cases in each group.The study group was treated with combined intravenous anesthesia under non-tracheal intubation with reserved spontaneous breathing,and the thoracic sympathetic nerve resection was performed with artificial pneumothorax.The control group received thoracic sympathectomy under combined intravenous anesthesia with double lumen endotracheal intubation.The clinical indexes of the two groups were compared.Results There was no significant difference in the operative time and incidence of compensatory hyperhidrosis between the two groups(P>0.05).The time of preoperative anesthesia duration,postoperative recovery time,visual analog scale/score,and length of hospital stay in the study group were less than those in the control group(P<0.05),the incidence of postoperative irritant cough,throat discomfort was lower than that in the control group(P<0.05).Conclusions Thoracoscopic thoracic sympathectomy assisted by artificial pneumothorax is safe and feasible for primary palmar hyperhidrosis.