摘要
目的探讨电视胸腔镜外科手术治疗原发性手汗症的可行性。方法 2009年6月～2010年6月我院在电视胸腔镜下行部分胸交感神经切除术(endoscopic thoracic sympathectomy,ETS)治疗手汗症22例。手术采用全麻下双腔气管插管,取30～45°半坐位,两臂伸展90°,双孔径路,术侧肺停止通气以显露上纵隔,用钩状电刀切除胸3交感神经节。双侧手术可于同一体位下完成。结果本组术后双手与腋下干燥、温暖、红润,次日起床活动,疼痛轻微,术后2～3 d复查胸部X线无明显异常出院,出院后即参加正常工作与学习。22例均无严重并发症,术后仅有伤口轻微疼痛,躯干代偿性多汗症状轻微。随访2～5个月,无复发。结论在电视胸腔镜下行部分ETS能良好显露胸交感神经链,解剖定位准确,创伤小,安全可靠,术后恢复快,且疗效确切而持久。
Objective To investigate the feasibility of video-assisted thoracic surgery technique in treatment of palmar hyperhidrosis.Methods 22 patients with palmar hyperhidrosis underwent partial Video-assisted endoscopic transthoracic sympathectomy(ETS) during June 2009 and June 2010.Double cavity tracheal cannula was used in the patients after general anaesthesia,and all the patients sat at 30～45° with upper arms stretching at 90°.After ventilation on the operated lung stopped,the two-sided surgery was performed at the same posture by exposing mediastinum superius and sympathectomy with falcate electric scalpel through a 2-hole EST pathway.Results After surgery,both hands in 22 patients were arid and florid,and no severe complications occurred.Compensatory torso hyperhidrosis occurred occasionally.After a 2 to 5-month follow-up,no relapse was reported. Conclusion Partial Video-assisted ETS can expose the chest sympathetic chain and locate the exact position.It is safe,less invasive,and helpful in early recovery with prolonged effect.
出处
《解放军医药杂志》
CAS
2011年第A04期45-46,共2页
Medical & Pharmaceutical Journal of Chinese People’s Liberation Army
