手汗症胸交感神经链切断术后生活质量分析

摘要

目的：探讨手汗症胸腔镜胸交感神经链切断术后的生活质量。方法2011年8月～2014年10月，对61例手汗症全麻下行胸腔镜双侧交感神经链切断术，电钩直接灼断T3或T4交感神经链。术后通过电话、邮件对患者进行生活质量问卷随访，评价手术疗效、副作用和生活质量。结果61例手术均获成功，术后手掌多汗症状全部消失，无严重并发症。术后代偿性多汗29例（47．5％）。与术前相比，术后1个月皮肤病生活质量指数量表（ Dermatology Life Quality Index，DLQI）得分明显下降（13．88±4．34 vs．3．82±3．36，t＝9．969，P＝0．000），SF-36量表（The Short Form 36 Health Survey Scale）中生理机能、生理职能、情感职能、精神健康4个方面得分明显升高（78．56±12．41 vs．93．53±9．62，t＝－3．626，P＝0．002；33．78±31．80 vs．86．76±29．47， t＝－5．053，P＝0．000；52．94±40．92 vs．90．20±25．72， t＝－3．172，P＝0．006；64．94±18．84 vs．76．82±15．92， t＝－3．681，P＝0．012）。结论胸腔镜下T3、T4交感神经链切断术是治疗手汗症安全有效的方法，能显著提高患者术后生活质量，主要表现在生理机能、生理职能、情感职能、精神健康4个方面。%Objective To investigate quality of life after thoracic sympathectomy for palmar hyperhidrosis. Methods From August 2011 to October 2014, a total of 61 patients with primary palmar hyperhidrosis underwent bilateral endoscopic thoracic sympathectomy.The T3 or T4 sympathetic chain was burned by using a electric hook.The patients’ follow-up data were collected by using telephone questionnaire and email to assess efficacy, side effects, and quality of life. Results The operation was successfully performed in all the patients and their palmar hyperhidrosis was completely alleviated after operation. No serious postoperative complications occurred.Compensatory hyperhidrosis occurred in 29 patients (47.5%).The scores of the Dermatology Life Quality Index (DLQI) at 1 month after surgery were remarkably decreased than before operation (13.88 ±4.34 vs.3.82 ±3.36, t=9.969, P=0.000).The scores of Short Form 36 Health Survey Scale (SF-36) on aspects of physical functioning, role physical, role emotional, and mental health at 1 month after surgery were remarkably improved (78.56 ±12.41 vs.93.53 ±9.62, t=-3.626, P=0.002;33.78 ±31.80 vs.86.76 ±29.47, t=-5.053, P=0.000;52.94 ±40.92 vs.90.20 ±25.72, t=-3.172, P=0.006;64.94 ±18.84 vs.76.82 ±15.92, t=-3.681, P=0.012). Conclusion Both T3 and T4 sympathectomy are safe and effective methods which can effectively improve the quality of life on aspects of physical functioning, role physical, role emotional, and mental health.