基于5mm胸腔镜+CO_(2)人工气胸微单孔方法行交感神经切断手术在手汗症微创手术中的应用效果

Application of sympathectomy based on 5 mm thoracoscope and CO_(2) artificial pneumothorax micro single hole method in minimally invasive surgery for hand hyperhidrosis

目的探究基于5 mm胸腔镜+CO_(2)人工气胸微单孔方法行交感神经切断手术在手汗症微创手术中的应用效果。方法选取2017年1月至2020年7月本院收治的手汗症患者20例,随机分为甲组(传统胸腔镜手术治疗,n=13)和乙组(基于5 mm胸腔镜+CO_(2)人工气胸微单孔方法,n=7),比较两组临床效果。结果术后,两组无手汗率、轻微手汗率、复发率比较差异无统计学意义。术后,乙组疼痛评分低于甲组,乙组手术时间、住院时间均短于甲组(P<0.05)。术前,两组DLQI评分比较差异无统计学意义;术后,两组DLOI评分均低于术前,且乙组低于甲组(P<0.05)。乙组切口不愈合率低于甲组(P<0.05)。结论应用基于5 mm胸腔镜+CO_(2)人工气胸微单孔方法行交感神经切断术治疗手汗症效果显著,可明显改善患者临床症状,且安全性高,值得临床推广运用。

Objective To explore the effect of sympathectomy based on 5 mm thoracoscope and CO_(2) artificial pneumothorax micro single hole method in minimally invasive surgery for hand hyperhidrosis.Methods 20 patients with palmar hyperhidrosis treated in our hospital from January 2017 to July 2020 were randomly divided into groupA(traditional video-assisted thoracoscopic surgery,n=13)and group B(based on 5 mmvideo-assisted thoracoscopy+CO_(2) artificial pneumothoraxmicro single holemethod,n=7).The clinical effects of the two groups were compared.Results There was no statistical difference in no hand sweat rate,slight hand sweat rate and recurrence rate between the two groups.After operation,the postoperative pain score in group B was lower than that in groupA,the operation time and hospital stay in group B were shorter than those in groupA(P<0.05).Before operation,there was no significant difference in DLQI score between the two groups;after operation,the DLOI score in both groups was lower than that before treatment,and the group B was lower than group A(P<0.05).The rate of incision nonunion in group B was lower than group A(P<0.05).Conclusion Sympathetic neurotomy based on 5 mm thoracoscope and CO_(2) artificial pneumothorax micro single hole is effective in the treatment of hand hyperhidrosis,can significantly improve the clinical symptoms,and the safety is high,it is worthy of clinical application.