[1]许志扬 许建新* 林建生 关军 郑新阳 施海展 陈信淳.手汗症胸交感神经链切断术后生活质量分析[J].中国微创外科杂志,2015,15(7):635-640.
　Xu Zhiyang,Xu Jianxin,Lin Jiansheng,et al.Research on Quality of Life After Thoracic Sympathectomy for Palmar Hyperhidrosis[J].Chinese Journal of Minimally Invasive Surgery,2015,15(7):635-640.
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手汗症胸交感神经链切断术后生活质量分析()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
15
期数:
2015年7期
页码:
635-640
栏目:
论著
出版日期:
2015-07-20

文章信息/Info

Title:
Research on Quality of Life After Thoracic Sympathectomy for Palmar Hyperhidrosis
作者:
许志扬 许建新* 林建生 关军 郑新阳 施海展 陈信淳
（福建医科大学教学医院莆田市第一医院胸心外科，莆田351100）
Author(s):
Xu Zhiyang;  Xu Jianxin;  Lin Jiansheng;  et al.
Department of Thoracic Surgery, Putian First Hospital, Fujian Medical University Teaching Hospital, Putian 351100, China
关键词:
胸交感神经链切断术; 手汗症; 生活质量
Keywords:
Hyperhidrosis; Sympathectomy; Quality of life
分类号:
R758.74+3;R655
文献标志码:
A
摘要:
目的探讨手汗症胸腔镜胸交感神经链切断术后的生活质量。方法2011年8月~2014年10月，对61例手汗症全麻下行胸腔镜双侧交感神经链切断术，电钩直接灼断T3或T4交感神经链。术后通过电话、邮件对患者进行生活质量问卷随访，评价手术疗效、副作用和生活质量。结果61例手术均获成功，术后手掌多汗症状全部消失，无严重并发症。术后代偿性多汗29例（47.5%）。与术前相比，术后1个月皮肤病生活质量指数量表(Dermatology Life Quality Index，DLQI)得分明显下降(13.88±4.34 vs. 3.82±3.36，t=9.969，P=0.000)，SF36量表(The Short Form 36 Health Survey Scale)中生理机能、生理职能、情感职能、精神健康4个方面得分明显升高(78.56±12.41 vs. 93.53±9.62,t=-3.626，P=0.002; 33.78±31.80 vs. 86.76±29.47, t=-5.053，P=0.000; 52.94±40.92 vs. 90.20±25.72, t=-3.172，P=0.006; 64.94±18.84 vs. 76.82±15.92, t=-3.681，P=0.012)。结论胸腔镜下T3、T4交感神经链切断术是治疗手汗症安全有效的方法，能显著提高患者术后生活质量，主要表现在生理机能、生理职能、情感职能、精神健康4个方面。
Abstract:
ObjectiveTo investigate quality of life after thoracic sympathectomy for palmar hyperhidrosis. MethodsFrom August 2011 to October 2014, a total of 61 patients with primary palmar hyperhidrosis underwent bilateral endoscopic thoracic sympathectomy. The T3 or T4 sympathetic chain was burned by using a electric hook. The patients’ followup data were collected by using telephone questionnaire and email to assess efficacy, side effects, and quality of life.ResultsThe operation was successfully performed in all the patients and their palmar hyperhidrosis was completely alleviated after operation. No serious postoperative complications occurred. Compensatory hyperhidrosis occurred in 29 patients (47.5%). The scores of the Dermatology Life Quality Index (DLQI) at 1 month after surgery were remarkably decreased than before operation (13.88±4.34 vs. 3.82±3.36, t=9.969, P=0.000). The scores of Short Form 36 Health Survey Scale (SF36) on aspects of physical functioning, role physical, role emotional, and mental health at 1 month after surgery were remarkably improved (78.56±12.41 vs. 93.53±9.62, t=-3.626, P=0.002; 33.78±31.80 vs. 86.76±29.47, t=-5.053, P=0.000; 52.94±40.92 vs. 90.20±25.72, t=-3.172, P=0.006; 64.94±18.84 vs. 76.82±15.92, t=-3.681, P=0.012).ConclusionBoth T3 and T4 sympathectomy are safe and effective methods which can effectively improve the quality of life on aspects of physical functioning, role physical, role emotional, and mental health.

参考文献/References:

[1]Abd Ellatif ME,Hadidi AE， Musa AM,et al.Optimal level of sympathectomy for primary palmar Hyperhidrosis: T3 versus T4 in a retrospective Cohort study.Int J Surg,2014,12(8):778-782.
[2]Lai YT，Yang LH，Chio CC，et al.Complications in patients with palmar hyperhidmsis treated with transthoracic endoscopic sympathectomy.Neurosurgery,1997,41(1):110-113．
[3]许建新,林建生,康明强,等.胸腔镜下不同节段胸交感神经链切断术治疗手汗症的疗效比较.中国微创外科杂志,2011,11(9):832-836.
[4]Tetteh HA,Groth SS,Kast T,et al.Primary palmoplantar hyperhidrosis and thoracoscopic sympathectomy:a new objective assessment method.Ann Thorac Surg,2009,87(1):267-274.
[5]张明圆.精神科评定量表手册.第2版.长沙：湖南科学技术出版社,1998.35.
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[8]李宁秀,刘朝杰,李俊,等.四川省城乡居民SF36评价参考值.华西医科大学学报，2001,32(1):43-47.
[9]黄立鹏,朱恒立,冯学岗,等.军人手汗症胸交感神经切除术后心理变化的研究.福建医药杂志,2014,36(1):54-56.
[10]宋志芳,韩兆杰,林琳,等.SF36量表评价胸外科住院患者生活质量的信度和效度.中国胸心血管外科临床杂志，2014,21(2):164-167.
[11]Baroncello JB,Baroncello LR,Schneider EG,et al.Evaluation of quality of life before and after videothoracoscopic simpathectomy for primary hyperhidrosis.Rev Col Bras Cir,2014,41(5):325-330.
[12]王妍妍,石国美,冯通慧,等.银屑病与湿疹患者生活质量和经济负担的比较.南京医科大学学报（社会科学版）,2013,13(1):36-42.
[13]王晓玲,赵天恩,张喜芹.简体中文版皮肤病生活质量指标信度和效度初探.中华流行病学杂志，2004,25(9)：791-793．
[14]de Campos JR,Kauffman P,Werebe Ede C,et al.Quality of life, before and after thoracic sympathectomy: report on 378 operated patients.Ann Thorac Surg,2003,76(3):886-891.
[15]Wolosker N,Yazbek G,Ishy A,et al.Is sympathectomy at T4 level better than at T3 level for treating palmar hyperhidrosis?J Laparoendosc Adv Surg Tech,2008,18(1):102-106.[1]Abd Ellatif ME,Hadidi AE， Musa AM,et al.Optimal level of sympathectomy for primary palmar Hyperhidrosis: T3 versus T4 in a retrospective Cohort study.Int J Surg,2014,12(8):778-782.
[2]Lai YT，Yang LH，Chio CC，et al.Complications in patients with palmar hyperhidmsis treated with transthoracic endoscopic sympathectomy.Neurosurgery,1997,41(1):110-113．
[3]许建新,林建生,康明强,等.胸腔镜下不同节段胸交感神经链切断术治疗手汗症的疗效比较.中国微创外科杂志,2011,11(9):832-836.
[4]Tetteh HA,Groth SS,Kast T,et al.Primary palmoplantar hyperhidrosis and thoracoscopic sympathectomy:a new objective assessment method.Ann Thorac Surg,2009,87(1):267-274.
[5]张明圆.精神科评定量表手册.第2版.长沙：湖南科学技术出版社,1998.35.
[6]Ware JE Jr,Kosinski M,Bayliss MS,et al.Comparison of methods for the scoring and statistical analysis of SF36 health profile and summary measures: summary of results from the Medical Outcomes Study.Med Care,1995,33(4 Suppl):AS264-AS279.
[7]张作记.行为医学量表手册.中国行为医学科学,2001,10(特刊):19-24．
[8]李宁秀,刘朝杰,李俊,等.四川省城乡居民SF36评价参考值.华西医科大学学报，2001,32(1):43-47.
[9]黄立鹏,朱恒立,冯学岗,等.军人手汗症胸交感神经切除术后心理变化的研究.福建医药杂志,2014,36(1):54-56.
[10]宋志芳,韩兆杰,林琳,等.SF36量表评价胸外科住院患者生活质量的信度和效度.中国胸心血管外科临床杂志，2014,21(2):164-167.
[11]Baroncello JB,Baroncello LR,Schneider EG,et al.Evaluation of quality of life before and after videothoracoscopic simpathectomy for primary hyperhidrosis.Rev Col Bras Cir,2014,41(5):325-330.
[12]王妍妍,石国美,冯通慧,等.银屑病与湿疹患者生活质量和经济负担的比较.南京医科大学学报（社会科学版）,2013,13(1):36-42.
[13]王晓玲,赵天恩,张喜芹.简体中文版皮肤病生活质量指标信度和效度初探.中华流行病学杂志，2004,25(9)：791-793．
[14]de Campos JR,Kauffman P,Werebe Ede C,et al.Quality of life, before and after thoracic sympathectomy: report on 378 operated patients.Ann Thorac Surg,2003,76(3):886-891.
[15]Wolosker N,Yazbek G,Ishy A,et al.Is sympathectomy at T4 level better than at T3 level for treating palmar hyperhidrosis?J Laparoendosc Adv Surg Tech,2008,18(1):102-106.

备注/Memo

备注/Memo:
基金项目：福建省卫生厅青年科研基金（2012144）*通讯作者，Email：xujianxin8210@126.com
更新日期/Last Update: 2016-01-04