胸腔镜胸交感神经干切除术治疗手和腋窝多汗症.docxVIP

·8 ·  HYPERLINK / ? 1994-2006 China Academic Journal Electronic Publishing House. All rights reserved.  第 8 卷第 8 期 2002 年 8 月 中 国 内 镜 杂 志 China Journal of Endoscopy Vol. 8 No . 8 Aug. 2002  ·论著· 胸腔镜胸交感神经干切除术治疗手和腋窝多汗症 南京大学医学院临床学院 ,南京军区总医院 (210002) 姚学权 刘福坤 黎介寿 目的 :本文评价了胸腔镜交感神经干切断术治疗手汗症的安全性和有效性 。方法 :自 1996 年 6 月～2000 年 12 月 ,38 例多汗症患者在全麻双腔插管下行双侧胸腔镜胸交感神经切除术 。男 18 例 ,女 20 例 ,平均年龄 24. 6 岁 (14～46 岁) 。单纯手汗症者采用电凝毁损胸2 交感神经节 ;手汗症合并腋窝多汗症 ,则切除胸2～4 交感 神经节 。术毕排出胸腔残余气体 ,不置胸腔引流管 。结果 :术后多汗症状全部消失 。麻醉清醒后 ,病人双手干 燥而温暖 。全组无手术死亡 。平均双侧手术时间 36min ( 12～90min) ,平均住院时间 5. 8d 。平均随访时间 33. 4 月 (6～54 月) 。15 例 (39. 5 %) 病人出现上肢以外的代偿性多汗 ,但基本可以忍受 ,不影响生活 ,无需进 一步治疗 。无复发病例 ,病人满意 。结论 :胸腔镜胸交感神经切除术是手汗症和腋窝多汗症的最有效的微创 治疗手段 。 关键词 胸交感神经干切除术 手汗症 多汗症 分类号 R747 THO RACOSCOPIC SYMPATHECTOMY FO R PRIMARY PALMAR AND AXILL ARY HYPERHID ROSIS Y ao X uequan , L i u Fuk u n , L i J ieshou General Hospital of Nanjing Command , Medical School of Nanjing U niversit y ,Nanjing 210002 AbstractOb jective :The aim of t his study was to evaluate t he efficacy and safety of t horacoscopic sympat hec2 tomies for primary and axillary hyperhidrosis. Methods :From J une 1996 to December 2000 , 38 t horacoscopic sym2 pat hectomies( TS) were performed. There were 18 males and 20 females wit h a mean age of 24. 6 years (rang ,14 to 46 years) . The procedures were performed wit h t he patients under general anest hesia using a double - lumen endo2 tracheal tube. In palmar hyperhidrosis t he second t horacic sympat hetic ganglia were destroyed by electrocautery. In axillary hyperhidrosis t he second to fourt h ganglion were cut off . Results : The symptoms disappeared completely in all patients immediately after t he operation. Their hands were dry and warm when t hey waked up f rom anaest hesia. There was no surgical mortality. Median operation time for a bilateral procedure is 36 min. ( range , 12～90min) . The average hospital stay was 5. 8 days. The mean follow - up time was 33. 4 mont hs ( range , 6～ 54mont