加速康复外科理念下的日间模式胸腔镜下交感神经切断术治疗手汗症的临床效果分析

Clinical Effect Analysis of Daytime Mode of Endoscopic Thoracic Sympathectomy in Treatment of Palmar Hyperhi⁃drosis Under Enhanced Recovery After Surgery Concept

目的:探讨加速康复外科(ERAS)理念下的日间模式胸腔镜下交感神经切断术(ETS)治疗手汗症的临床效果。方法:选取2021年4月—2021年11月南京大学医学院附属鼓楼医院收治的78例手汗症患者作为研究对象,根据住院方式分为普通病房组与日间手术组,各39例。普通病房组采用常规ETS管理,日间手术组采用基于ERAS理念的ETS管理。对比两组临床指标、术后并发症发生情况及术后咽喉痛发生率。结果:两组手术时间、术中出血量比较,差异无统计学意义(P>0.05);日间手术组住院时间短于普通病房组,医疗费用、术后疼痛数字评分法评分、恶心呕吐发生率低于普通病房组,差异有统计学意义(P<0.05)。两组均无术中出血、心脏骤停、乳糜胸、霍纳综合征发生。日间手术组术后咽喉发生率低于普通病房组,差异有统计学意义(P=0.027)。结论:ERAS理念下的日间模式ETS治疗手汗症临床效果显著,可减轻患者疼痛,促进患者康复,减少医疗费用。

Objective:To explore the application effect of daytime mode of endoscopic thoracic sympathectomy(ETS)in treatment of palmar hyperhidrosis under enhanced recovery after surgery(ERAS)concept.Methods:A total of 78 patients with palmar hyper⁃hidrosis in Affiliated Drum Tower Hospital,Medical School of Nanjing University from April 2021 to November 2021 were se⁃lected as the study subjects.According to the surgical method,they were divided into general ward group and daytime surgery group,with 39 cases in each group.The general ward group used routine ETS management,and the daytime surgery group used ETS management based on the ERAS concept.The clinical indexes,postoperative complications and postoperative sore throat inci⁃dence were compared between the two groups.Results:There was no significant difference in operation time and intraoperative blood loss between the two groups(P>0.05).The length of hospital stay in the daytime surgery group was shorter than that in the general ward group,and the medical costs,postoperative pain numerical scoring scores,and the incidence of nausea and vomiting in the daytime surgery group were lower than those in the general ward group,with statistically significant difference(P<0.05).There were no intraoperative bleeding,cardiac arrest,chylothorax,or Horner syndrome in two groups.The incidence of postopera⁃tive sore throat in the daytime surgery group was lower than that in the general ward group,and the difference was statistically sig⁃nificant(P=0.027).Conclusion:The clinical effect of daytime mode of ETS under the concept of ERAS in the treatment of palmar hyperhidrosis is significant,which can reduce the pain of patients,promote the recovery of patients and reduce medical costs.