电视胸腔镜下单孔法与双孔法胸交感神经链切断术治疗原发性手汗症的对比.pdf

  本文关键词：电视胸腔镜下单孔法与双孔法胸交感神经链切断术治疗原发性手汗症的对比，由笔耕文化传播整理发布。

网友wz_198622近日为您收集整理了关于电视胸腔镜下单孔法与双孔法胸交感神经链切断术治疗原发性手汗症的对比的文档，希望对您的工作和学习有所帮助。以下是文档介绍：art to finished sewing the skin, without anesthesia andrecovery time) of one trocar group was significantly shorter ((13.4±2.0)min vs (18.3±2.3) min,P<0.01). There were no plications inall patients. Postoperative palm sweating symptoms were disappeared andpalm turned dry and warm . 174 patients were followed up for 1-24months, on average (11.0±7.6) months. One month after surgery, theincidence of incision residual pain of one trocar group was significantlylower than that of two trocars group(25.5% vs 41.6%, P<0.01).34 patientshad appeared various degrees of pensatory sweating,accounting for 19.5% (34/174) in the two groups of patients. 16 patientsof one trocar group had pensatory sweating, accounting for16.2% (16/99).3 patients of one trocar group had pensatorysweating, accounting for 3.0% (3/99). 18 patients of two trocars grouphad pensatory sweating, accounting for 24.0% (18/75).2 patientsof two trocars group had pensatory sweating , accountingfor 2.7% (2/75). The difference between the two groups was notstatistically significant (P> 0.05) .Two groups of patients are satisfiedwith the cosmetic results of the incision. In one trocar group ,patients whofelt very satisfied was accounting for 84.8 % (84 /99) and those feelingsatisfied is accounting for 15.2% ( 15/99 ) .While in two trocars group,patients who felt very satisfied was accounting for 69.3% (52 /75) andthose feeling satisfied is accounting for 30.7% (23 /75) . The satisfactionbetween the two groups is statistically significant(X2= 6.018 , P < 0.05 ).Conclusion Endoscopic thoracic sympathectomy with one trocar forprimary palmar hyperhidrosis is more simple,more safe effective,moreminimally invasive,more beautiful and more worthy clinical promotedapplication.[Key words] Palmar hyperhidrosis;Thoracic sympathectomy;Thoracoscope;one trocar前言原发性手汗症(PPH,primary palmar hyperhidrosis)是指支配手部汗腺的交感神经兴奋性异常升高,导致不受外界温度影响手部汗腺异常分泌亢进的综合症[1]。该病具体的发病机制至今为止仍然未弄清楚。虽然手汗症对患者的身体健康无太大影响,但是却常常因为患者手部大量出汗而影响其正常生活、工作和社交行为,同时也严重地影响了患者的身心健康。因此原发性手汗症患者仍应该积极进行治疗。而胸腔镜下胸交感神经链切断术(ETS , endoscopic thoracicsympathectomy)通过阻断交感神经节后纤维对手汗症患者手掌汗腺的支配,使其分泌减少,是目前治疗原发性手汗症惟一能够达到长期有效的方法。其疗效稳定、持久,在临床上已取得了良好的效果[2]。本文对2011年01月至2012年12月在福建医科大学附属第一医院行电视胸腔镜下单孔法胸交感神经链切断术与双孔法胸交感神经链切断术的患者的临床资料进行了对比分析,比较两种手术方法之间的差异,提出了电视胸腔镜下单孔法胸交感神经链切断术治疗原发性手汗症的优势,现总结比较如下。1 资料与方法1.1 病例选择1.1.1 病例选择标准Lai 等[3]根据患者手汗严重程度将其分为 3 度:1.轻度:手掌潮湿;2.中度:手掌出汗时湿透一只手帕;3.重度:手掌出汗时呈滴珠状。我们选择从 2011 年01 月至 2012 年 12 月在福建医科大学附属第一医院诊断为重度原发性手汗症的住院患者,术前均详细询问病史,以双手多汗为主诉入院,显著影响患者日常生活、学习及工作。术前常规行胸部 CT 平扫及心电图检查排除肺结核、心血管疾病等相关疾病引起的全身多汗,在必要时做相关检查以排除甲亢、糖尿病等疾病引起的多汗。所有患者所行的手术方式均为电视胸腔镜下胸交感神经 R3 节段主干+侧支切断的方式。1.1.2 病例排除标准术前患有甲状腺功能亢进、糖尿病、心血管疾病、肺结核等疾病引起的继发

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  本文关键词：电视胸腔镜下单孔法与双孔法胸交感神经链切断术治疗原发性手汗症的对比，由笔耕文化传播整理发布。