阻断胸交感神经干治疗头面部多汗58例随访结果报告
神经,,胸腔镜;交感神经阻滞;多汗症;随访研究,1资料与方法,2结果,3讨论,参考文献:
【摘要】目的:评价胸腔镜下阻断胸交感神经干夹闭术治疗头面部多汗的远期疗效。方法:双腔或单腔气管插管全麻,患者取侧卧位,单肺通气,取腋中线第2~3肋间、腋后线4~5肋间穿入7mm与45mm Trocar,放入手术器械与胸腔镜光学视管,找到交感神经链,用钛夹夹闭T2、T2下缘、T3或T4处交感神经干。膨肺,缝合或粘合切口。将体位改为右侧卧位,改变体位行对侧手术。电话随访术后1个月后的患者。结果:58例头面部多汗患者,手术时间30~130min,平均(631±201)min。25例患者术中发现有神经侧支,做了相应的侧支切断或夹闭术,术后2~3d出院。对术后超过1个月的54例患者进行随访,共随访到47例(870%),随访时间1~18个月,平均随访62个月。随访术后头汗、鼻部出汗、手汗、脚汗、腋汗、脸红、颈部出汗的消失率分别为979%、100%、100%、75%、60%、917%、100%。1例复发经再次手术治愈。术后代偿性出汗的总发生率为957%。后背、前胸、小腿、大腿、腹部、脚、腋下代偿性出汗的发生率分别为894%、872%、511%、447%、128%、64%、43%。对手术效果“非常满意”、“满意”、“不满意”分别为340%、638%、21%。总的满意率接近98%。术后7~10d均能恢复正常学习工作和体育锻炼。结论:胸腔镜下用钛夹夹闭第2肋表面胸交感神经干治疗头面部多汗,手术成功率高,手术安全,远期随访满意率高。【关键词】胸腔镜;交感神经阻滞;多汗症;随访研究
Craniofacial hyperhidrosis treated by blocking thoracic sympathetic trunk under endoscopic operation:with a report of 58 cases
GUO Shaohong,WANG Jingjing,YAN Jin,et a.
Minimally Invasive Surgery Center,Shaoxing Huayu Hospital of China Medical University,Shaoxing 312030,China
【Abstract】 Objective:To evaluate the longterm effects of the endoscopic thoracic sympathetic trunk blocking operation for treating craniofacial hyperhidrosisMethods: Endotracheal anesthesia by bicavity or monocavity tracheal cannula was used in these operations.Under lateral recumbent position,two trocars were punctured in 23 (or 34) and 45 rib interspaces.The operation instruments and optictube were send into pleural cavity to find sympathetic chainThe sympathetic nerve trunk at T2 rib, T2 rid inferior border ......
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