浙江创伤外科
浙江創傷外科
절강창상외과
ZHEJIANG JOURNAL OF TRAUMATIC SURGERY
2014年
6期
892-893,898
,共3页
王海涛%严志焜%许林海%朱理%戴备军
王海濤%嚴誌焜%許林海%硃理%戴備軍
왕해도%엄지혼%허림해%주리%대비군
胸腔镜%交感神经干切断术%手汗症%代偿性多汗
胸腔鏡%交感神經榦切斷術%手汗癥%代償性多汗
흉강경%교감신경간절단술%수한증%대상성다한
Video-assisted thoracoscope%Thoracic sympathectomy%Palmar hyperhidrosis%Compensatory hyperhidrosis
目的:比较胸腔镜下不同节段胸交感神经干切断术治疗手汗症的疗效和术后代偿性多汗的差异。方法本院自1995年7月至2011年12月,收治的原发性手汗症患者共1040例。依据切断胸交感神经节段的不同分为两组比较分析。A组(不保留T2神经节段)503例, B组(保留T2神经节段)537例。对上述两组病例进行随访观察,评定与比较两组之间的疗效以及代偿性多汗的发生情况。结果1040例患者随访到834例,随访率80.2%。到访两组手术成功率均为100%,术中、术后无严重并发症发生,术后12个月内两组代偿性多汗总体发生率37.8%(315/834)。两组代偿性多汗和重度代偿性多汗发生率的差异均有统计学意义(P<0.01或<0.05)。结论与经典的A组(不保留T2神经节段)胸交感神经干切断术相比,B组(保留T2神经节段)T3或T4胸交感神经干+旁路切断术式疗效确切,且能明显减少代偿性多汗的发生率,是一种较为合理的术式。
目的:比較胸腔鏡下不同節段胸交感神經榦切斷術治療手汗癥的療效和術後代償性多汗的差異。方法本院自1995年7月至2011年12月,收治的原髮性手汗癥患者共1040例。依據切斷胸交感神經節段的不同分為兩組比較分析。A組(不保留T2神經節段)503例, B組(保留T2神經節段)537例。對上述兩組病例進行隨訪觀察,評定與比較兩組之間的療效以及代償性多汗的髮生情況。結果1040例患者隨訪到834例,隨訪率80.2%。到訪兩組手術成功率均為100%,術中、術後無嚴重併髮癥髮生,術後12箇月內兩組代償性多汗總體髮生率37.8%(315/834)。兩組代償性多汗和重度代償性多汗髮生率的差異均有統計學意義(P<0.01或<0.05)。結論與經典的A組(不保留T2神經節段)胸交感神經榦切斷術相比,B組(保留T2神經節段)T3或T4胸交感神經榦+徬路切斷術式療效確切,且能明顯減少代償性多汗的髮生率,是一種較為閤理的術式。
목적:비교흉강경하불동절단흉교감신경간절단술치료수한증적료효화술후대상성다한적차이。방법본원자1995년7월지2011년12월,수치적원발성수한증환자공1040례。의거절단흉교감신경절단적불동분위량조비교분석。A조(불보류T2신경절단)503례, B조(보류T2신경절단)537례。대상술량조병례진행수방관찰,평정여비교량조지간적료효이급대상성다한적발생정황。결과1040례환자수방도834례,수방솔80.2%。도방량조수술성공솔균위100%,술중、술후무엄중병발증발생,술후12개월내량조대상성다한총체발생솔37.8%(315/834)。량조대상성다한화중도대상성다한발생솔적차이균유통계학의의(P<0.01혹<0.05)。결론여경전적A조(불보류T2신경절단)흉교감신경간절단술상비,B조(보류T2신경절단)T3혹T4흉교감신경간+방로절단술식료효학절,차능명현감소대상성다한적발생솔,시일충교위합리적술식。
Objective To analyze the efficacy of video-assisted thoracoscopic sympathectomy and the differences of compensatory hyper-hidrosis after sympathectomy in the treatment of palmar hyperhidrosis by different operative methods. Methods 1040 patients with palmar hyper-hidrosis being undergone video-assisted thoracoscopic bilateral sympathectomy were retrospectively studied during the period of July 1995 and De-cember 2011. The patients were divided into two groups for Group A (T2 not remained)and Group B (T2 remained) by different operative methods. Results All the cases were successfully performed for video assisted thoracoscopic bilateral sympathectomy without severe morbidity and mortality. 834 cases were followed up from 1040 patients. The incidence of compensatory hyperhidrosis of two groups were 37.8%(315/834).There were signifi-cant differences for compensatory hyperhidrosis and serious compensatory hyperhidrosis between group A and group B ( P<0.01 or P<0.05). Con-clusion Video-assisted thoracoscopic bilateral sympathecotomy is an effective operative method to cure hyperhidrosis. By comparing with the tradi-tional video-assisted thoracoscopic T2 sympathectomy in Group A, the T3 or T4 sympathecotomy plus resection procedure of bypass fiber in Group B is reasonable operative method to cure hyperhidrosis with the best curative effect and the lowest incidence of compensatory hyperhidrosis.