胸3～4与胸3～5交感神经干切除术治疗手足多汗症

摘要

Objective:To assess the efficacy and safety of T3-4 and T3-5 thoracic sympathectomy for primary palmoplantar hyperhidrosis (PH). Methods: Two hundred and thirty-night cases of PH patients who underwent T3-4 (group A, 155 cases) or T3-5 sympathectomy (group B, 84 cases) were enrolled. Results: No major complications or operation death was found. Palmar PH recessed in both groups and no recurrence was noted. There were totally 137 (58% ) patients who got plantar relief. Of those relieved patients, there were 82 (53% ) in group A and 55 (67% ) in group B (P =0. 02) , with significant difference There was no difference in compensatory sweating, (40% in group A and 36% in group B). Conclusion: (T3-4/5) sympathectomy was as effective as (T3-4) for palmar PH. and the latter was more effective for plantar PH, without additional complications. (T3-4/5) sympathectomy was more suitable for palmoplantar PH.%目的:比较胸3～4 (T3～4)与胸3～5(T3～5)交感神经干切除术治疗手足多汗症的安全性及有效性.方法:239例手足多汗症患者分别行T3～4切除术(A组,155例)与T3～4切除术加T5部分电灼切断(B组,84例),比较两组疗效、并发症及患者满意度.结果:全部患者无严重并发症及手术死亡,术后手多汗均得到缓解,随访期限内无复发.137例(58％)患者术后足汗消失或得到缓解,其中B组55例(67％),A组82例(53％),两组比较差异具统计学意义(P＜0.05).两组患者术后代偿性多汗发生率分别为40％(A组)和36％(B组),组间比较差异无统计学意义.结论:T3～4切除术与T3～4切除术加T5部分电灼切断对手多汗均具理想疗效,后者能提高足多汗缓解率而不增加并发症,适用于合并足多汗患者.