CAJ | 학술논문

目的：探讨左T4右T3交感神经链切断术治疗手汗症的可行性。方法2012-02至2014-04对45例手汗症行胸腔镜下胸交感神经链切断术，男19例，女26例，年龄15～42岁。患者自行选择哪种手术方式而随机进入两个组：A组为左T4右T3切断23例，B组为双侧T3链切断22例。结果所有手术均顺利完成，无严重并发症和围术期死亡病例。所有患者平均随访（12．6±9．5）个月。患者手掌多汗症状均改善。 A组9例（47．8％）的左侧手掌， A组2例（8．7％）和 B组2例（9．1％）的双侧手掌仍潮湿，左手潮湿率B组明显低于A组（9．1％ vs 47．8％，P＜0．01），AB两组右手潮湿率（8．7％ vs 9．1％）、疗效满意率均无统计学差异（91．3％vs 95．5％，P＞0．05）。66．7％的患者出现代偿性多汗（ compensatory hyperhidro-sis，CH），无重度CH。 A组3例中度CH明显低于B组9例（13．0％vs 40．9％，P＜0．05）。结论左T4右T3交感神经链切断术与双侧T3切断临床疗效相似，但又较双侧T3切断CH轻，说明左T4右T3交感神经链切断术是一种值得推荐的手术方法。
목적：탐토좌T4우T3교감신경련절단술치료수한증적가행성。방법2012-02지2014-04대45례수한증행흉강경하흉교감신경련절단술，남19례，녀26례，년령15～42세。환자자행선택나충수술방식이수궤진입량개조：A조위좌T4우T3절단23례，B조위쌍측T3련절단22례。결과소유수술균순리완성，무엄중병발증화위술기사망병례。소유환자평균수방（12．6±9．5）개월。환자수장다한증상균개선。 A조9례（47．8％）적좌측수장， A조2례（8．7％）화 B조2례（9．1％）적쌍측수장잉조습，좌수조습솔B조명현저우A조（9．1％ vs 47．8％，P＜0．01），AB량조우수조습솔（8．7％ vs 9．1％）、료효만의솔균무통계학차이（91．3％vs 95．5％，P＞0．05）。66．7％적환자출현대상성다한（ compensatory hyperhidro-sis，CH），무중도CH。 A조3례중도CH명현저우B조9례（13．0％vs 40．9％，P＜0．05）。결론좌T4우T3교감신경련절단술여쌍측T3절단림상료효상사，단우교쌍측T3절단CH경，설명좌T4우T3교감신경련절단술시일충치득추천적수술방법。
Objective To evaluate the effect and side effect of right T 3 combined with left T 4 sympathectomy in the surgical management of primary palmar hyperhidrosis (PPH)through randomized controlled tria1.Methods From February 2012 to Apr 2014, 45 patients(19 males and 26 females)with PPH were enrolled in the study and randomly assigned into Group A (n=23) who recieved right T3 combined with left T4 sympathectomy and and Group B(n=22) who underwent bilateral T3 sympathectomy.The curative effects and side effects were compared between the tow groups .Results All procedures were carried out successfully without severe morbidity or mortality.After a mean follow-up period of 12.6 months,symptoms of PPH were improved in all patients .The left hands in Group A had more wet palms compared with the left hands in Group B (47.8%vs 9.1%,P<0.01),but the right hands, moisture (8.7%vs 9.1%,P>0.05)and patients’ satisfaction (91.3%vs 95.5%,P>0.05)between Group A and B showed no statistically significant difference.Compensatory hyperhidrosis(CH) occurred in 66.7%of patients, and no patient was affected with severe CH .Moderate CH occurred in 3 cases and 9 cases respectively in groups A and B , and there was significant difference between the groups (13.0%vs 40.9%,P<0.05).Conclusions The procedure of right T3 combined with left T4 sympathectomy is an effective method which can improve quality of life and reduce compensatory hyperhidrosis .