摘要 目的 探讨左T4右T3交感神经链切断术治疗手汗症的可行性。方法 2012-02至2014-04对45例手汗症行胸腔镜下胸交感神经链切断术,男19例,女26例,年龄15～42岁。患者自行选择哪种手术方式而随机进入两个组:A组为左T4右T3切断23例,B组为双侧T3链切断22例。结果 所有手术均顺利完成,无严重并发症和围术期死亡病例。所有患者平均随访(12.6±9.5)个月。患者手掌多汗症状均改善。A组9例(47.8％)的左侧手掌, A组2例(8.7％)和 B组2例(9.1％)的双侧手掌仍潮湿,左手潮湿率B组明显低于A组(9.1% vs 47.8%,P＜0.01),AB两组右手潮湿率(8.7% vs 9.1%)、疗效满意率均无统计学差异(91.3% vs 95.5%,P>0.05)。66.7％的患者出现代偿性多汗(compensatory hyperhidrosis,CH),无重度CH。A组3例中度CH明显低于B组9例(13.0％ vs 40.9％,P＜0.05)。结论 左T4右T3交感神经链切断术与双侧T3切断临床疗效相似,但又较双侧T3切断CH轻,说明左T4右T3交感神经链切断术是一种值得推荐的手术方法。
Abstract：Objective To evaluate the effect and side effect of right T3 combined with left T4 sympathectomy in the surgical management of primary palmar hyperhidrosis (PPH)through randomized controlled tria1.Methods From February 2012 to Apr 2014,45 patients(19 males and 26 females)with PPH were enrolled in the study and randomly assigned into Group A (n=23) who recieved right T3 combined with left T4 sympathectomy and and Group B(n=22) who underwent bilateral T3 sympathectomy.The curative effects and side effects were compared between the tow groups.Results All procedures were carried out successfully without severe morbidity or mortality.After a mean follow-up period of 12.6 months,symptoms of PPH were improved in all patients. The left hands in Group A had more wet palms compared with the left hands in Group B (47.8％ vs 9.1％,P＜0.01),but the right hands, moisture (8.7% vs 9.1%,P>0.05)and patients’ satisfaction (91.3% vs 95.5%,P>0.05)between Group A and B showed no statistically significant difference.Compensatory hyperhidrosis(CH) occurred in 66.7% of patients, and no patient was affected with severe CH . Moderate CH occurred in 3 cases and 9 cases respectively in groups A and B, and there was significant difference between the groups (13.0％ vs 40.9％,P＜0.05). Conclusions The procedure of right T3 combined with left T4 sympathectomy is an effective method which can improve quality of life and reduce compensatory hyperhidrosis.
陈光春,文毅,廖小勇,邱干,郭伟华,陈景松,滕树炎,陈洁,吴维微. 左T4右T3与双侧T3交感神经链切断术治疗手汗症疗效比较[J]. 武警医学, 2014, 25(11): 1107-1110.
CHEN Guangchun, WEN Yi, LIAO Xiaoyong, QIU Gan, GUO Weihua, CHEN Jingsong, TENG Shuyan, CHEN Jie, and WU Weiwei. Comparison of bilateral T3 sympathectomy versus right T3 combined with left T4 sympathectomy in treatment of primary palmar hyperhidrosis. Med. J. Chin. Peop. Armed Poli. Forc., 2014, 25(11): 1107-1110.
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2014, Vol. 25 
