摘要
系统回顾我国20年来有关手汗症微创治疗临床与基础系列研究证据,针对当前手汗症微创治疗的热点问题和难点问题进行深入探讨,对手汗症的定义、临床表现、诊断标准与分级、手术适应证与禁忌证、手术方法及并发症的处理,尤其是对术后代偿性多汗(compensatory hyperhidrosis,CH)等领域形成新的共识。肯定胸腔镜下胸交感神经切断术(endoscopic thoracic sympathicotomy,ETS)仍是当前治疗手汗症最有效且值得推广的方法,CH为最常见的副作用。为了降低CH发生率,减轻患者困扰,提高患者满意度,指南特别强调:重视术前谈话和告知、充分与患者沟通、谨慎选择患者、杜绝手术适应证扩大化、优化手术术式等策略是防治CH的关键。详细介绍各种降低C H发生率方法的利与弊。为规避手术风险、重视围手术期的处理、进一步提高手术疗效提供一份权威性指导性文件。
This guideline system atically review ed and summ arized the 20 years’clin ical and basic research experience of minimally invasive treatment of palm ar hyperhidrosis(PH)in China,and discussed the hot and difficult issues of minim ally invasive treatm ent of PH.We have form ed a new consensus of PH interms of its definition,clinical manifestations,diagnostic criteria and classification,surgical indications and contraindications,surgical procedures and m anagem ent of complications,especially in the area of postoperative com pensatory hyperhidrosis(CH).This guideline confirm ed that endoscopic thoracic sym pathicotom y(ETS)was the m ost effective treatm ent for PH and that CH was the m ost com m on side effect.Inorder to red uce the incidence of C H,elim inate patient's distress and im prove patient's satisfaction,the guideline em phasized that the keys to p revent CH were to pay atten tion to p re-op erative interview,com m unicate with patients,select patients carefully,avoid the enlargem ent of operative indication and optimize operative procedure.This guideline also introduced the advantages and disadvantages o f various methods to reduce the incidence of CH.We provided this authoritative guidance docum ent in ord er to avoid the surgical risk,strengthen the perioperative management and im prove the sugery effect.
作者
涂远荣
刘彦国
中国手汗症微创治疗临床指南编写委员会
TU Yuanrong;LIU Yanguo;Writing Board of Clinical Guidelines for Minimally Invasive Treatment of Palmar Hyperhidrosis in China(Department of Thoracic Surgery,The First Affiliated Hospital of Fujian Medical University,Fuzhou,350005,P.R.China;Department of Thoracic Surgery,Peking University People's Hospital,Beijing,100044,P.R.China;不详)
出处
《中国胸心血管外科临床杂志》
CSCD
北大核心
2021年第10期1133-1139,共7页
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
关键词
手汗症
胸腔镜下胸交感神经切断术
代偿性多汗
指南
Palm ar hyperhidrosis
endoscopic thoracic sym pathicotom y
com pensatory hyperhidrosis
guideline
