麻醉监护下局部麻醉单孔胸腔镜下双侧胸交感神经切断术治疗多汗症

发布时间：2018-02-04 00:07

  本文关键词： 多汗症 双侧胸交感神经切断术 胸腔镜 局部麻醉 麻醉监护　出处：《实用中西医结合临床》2016年05期 　论文类型：期刊论文

【摘要】：目的:探讨麻醉监护下局部麻醉单孔胸腔镜下双侧胸交感神经切断术治疗多汗症的可行性及安全性。方法:选择2013年4月~2015年5月在我院手术治疗的多汗症患者56例进行研究,随机分为对照组28例。研究组28例,对照组:在气管插管全麻下采用5 mm单孔胸腔镜下进行双侧胸T3~T5交感神经干切断术治疗原发性多汗症。研究组:在麻醉监护下局部麻醉采用5 mm单孔胸腔镜下进行双侧胸T3~T5交感神经干切断术治疗原发性多汗症。结果:所有患者手术均顺利完成。对照组:手术时间(57.73±12.3)min,麻醉时间(81.33±9.90)min,术后清醒出手术室时间(41.59±12.73)min,住院费用(8 556.69±1 006.53)元,术后出现咽喉部不适23例(82%),手汗缓解率100%。研究组:所有患者术中非气管插管全麻,手术时间(56.36±11.97)min,麻醉时间(60.95±11.17)min,术后清醒出手术室时间(11.59±4.73)min,住院费用(7 831.73±664.95)元,术后咽喉部不适2例(7%),手汗缓解100%。两组比较:手术时间相当,差异没有统计学意义(P=0.8430.05),研究组麻醉时间少,差异有统计学意义(P=0.0140.05),术后清醒出手术室时间短,差异有统计学意义(P=0.0080.05),住院费用少,差异有统计学意义(P=0.0410.05),术后咽喉部不适较少,差异有统计学意义(P=0.0000.05)。结论:麻醉监护下局部麻醉单孔胸腔镜下双侧胸交感神经切断术治疗多汗症的方法是可行、安全的,较气管插管全麻的麻醉时间短,术后恢复快,同时可降低住院费用和减少术后咽喉部不适。
[Abstract]:Objective: to investigate the feasibility and safety of bilateral thoracic sympathetic neurotomy under local anesthesia under local anesthesia under single hole thoracoscopy in the treatment of hyperhidrosis. From April 2013 to May 2015, 56 cases of hyperhidrosis treated in our hospital were studied. They were randomly divided into control group (n = 28) and study group (n = 28). Control group: primary hyperhidrosis was treated with 5 mm single hole thoracoscopic thoracotomy under tracheal intubation under general anesthesia. Mm single hole thoracoscopy was performed for the treatment of primary hyperhidrosis by bilateral thoracotomy with T _ 3N _ 5 sympathetic trunk. Results: all patients were successfully operated on. 57.73 卤12.3 min. The time of anesthesia was 81.33 卤9.90 minutes, and the time of waking out of operation room was 41.59 卤12.73 minutes after operation. The cost of hospitalization was 8 556.69 卤1 006.53 yuan, 23 cases of pharyngopharynx discomfort occurred after operation. The relief rate of hand sweat was 100. The study group: all the patients received general anesthesia without tracheal intubation during operation, the operative time was 56.36 卤11.97 minutes, and the anesthesia time was 60.95 卤11.17 minutes. The time of awake operation room was 11.59 卤4.73 minutes after operation, the cost of hospitalization was 7 831.73 卤664.95 yuan, and the postoperative pharynx and larynx discomfort occurred in 2 cases (7 cases). Comparison between the two groups: the operation time was the same, the difference was not statistically significant (P < 0. 843 0. 05), and the anesthesia time of the study group was less than that of the control group. The difference was statistically significant (P < 0. 0140.05). The time of waking out of operation room after operation was short, the difference was statistically significant (P < 0. 0080.05), and the cost of hospitalization was less. The difference was statistically significant (P = 0.0410.05), and there was less pharynx and larynx discomfort after operation. Conclusion: the method of bilateral thoracic sympathetic neurotomy under local anesthesia under single hole thoracoscopy is feasible and safe in the treatment of hyperhidrosis. The anesthesia time of general anesthesia was shorter than that of tracheal intubation, the postoperative recovery was faster, and the hospitalization cost and postoperative pharyngopharynx discomfort could be reduced at the same time.
【作者单位】： 广东省高州市人民医院胸外科;
【分类号】：R614.3
【正文快照】： 多汗症是一种交感神经功能亢进导致的障碍性疾病[1],由于皮肤持续处于潮湿状态,会导致皮肤易受感染,给患者带来心理和社交方面的影响,从而严重影响患者的生活质量。单孔胸腔镜下双侧胸交感神经切断术是目前治疗多汗症最为有效的方法,该手术方法主要建立在全身麻醉的基础上实施，

本文编号：1488737