微小双孔法胸腔镜双侧胸交感神经链切断术在治疗手汗症中的应用效果

Micro-double-port Endoscopic Bilateral Thoracic Sympathectomy for Palmar Hyperhidrosis

目的观察微小双孔法胸腔镜双侧胸交感神经链切断术在治疗手汗症中的应用效果。方法选取2020年10月-2023年9月在我院诊治的64例手汗症患者为研究对象,采用随机数字表法分为对照组和观察组,各组32例。对照组采用普通胸腔镜单孔胸腔镜T4切断术治疗,观察组采用微小双孔法胸腔镜双侧胸交感神经链切断术治疗。比较两组临床疗效、手术指标、疼痛评分、手掌皮肤温度、并发症发生率、复发率。结果观察组治疗总有效率(96.88%)与对照组(93.75%)比较,差异无统计学意义(P>0.05);观察组手术切口、手术时间、住院时间均小于对照组(P<0.05);两组术中出血量比较,差异无统计学意义(P>0.05);观察组术后3、12、24 h的VAS评分均低于对照组(P<0.05);两组术后手掌温度均高于术前(P<0.05),但观察组与对照组比较,差异无统计学意义(P>0.05);观察组并发症发生率低于对照组(P<0.05);随访3个月,观察组复发率低于对照组(P<0.05)。结论微小双孔法胸腔镜双侧胸交感神经链切断术治疗手汗症效果确切,可缩短手术时间,减小手术切口,且可降低并发症发生率和复发率,具有较好的有效性、安全性。

Objective To observe the application effect of micro-double-port endoscopic bilateral thoracic sympathectomy in the treatment of palmar hyperhidrosis.Methods A total of 64 patients with palmar hyperhidrosis diagnosed and treated in our hospital from October 2020 to September 2023 were selected as the research objects.They were divided into control group and observation group by random number table method,with 32 patients in each group.The control group was treated with ordinary thoracoscopic single-hole thoracoscopic T4 amputation,and the observation group was treated with micro-double-port endoscopic bilateral thoracic sympathectomy.The clinical efficacy,surgical indicators,pain score,palm skin temperature,complication rate and recurrence rate were compared between the two groups.Results There was no significant difference in the total effective rate between the observation group(96.88%)and the control group(93.75%)(P>0.05).The incision,operation time and hospitalization time of the observation group were less than those of the control group(P<0.05),but there was no significant difference in intraoperative blood loss between the two groups(P>0.05).The VAS score of the observation group at 3,12 and 24 h after operation was lower than that of the control group(P<0.05).The palm temperature of the two groups after operation was higher than that before operation(P<0.05),but there was no significant difference between the observation group and the control group(P>0.05).The incidence of complications in the observation group was lower than that in the control group(P<0.05).After 3 months of follow-up,the recurrence rate of the observation group was lower than that of the control group(P<0.05).Conclusion Micro-double-port endoscopic bilateral thoracic sympathectomy is effective in the treatment of palmar hyperhidrosis,which can shorten the operation time,reduce the surgical incision,and reduce the incidence of complications and recurrence rate.It has good efficacy and safety.