[1]陈茂林 崔东** 张卫东 邱瑞兴 钱如林.双微孔与单孔胸腔镜治疗原发性手汗症的对比研究[J].中国微创外科杂志,2024,01(12):800-804.
　Chen Maolin,Cui Dong,Zhang Weidong,et al.A Comparative Study of Dualmicroport and Uniport Videoassisted Thoracoscopic Surgery for Palmar Hyperhidrosis[J].Chinese Journal of Minimally Invasive Surgery,2024,01(12):800-804.
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双微孔与单孔胸腔镜治疗原发性手汗症的对比研究()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
01
期数:
2024年12期
页码:
800-804
栏目:
临床研究
出版日期:
2024-12-25

文章信息/Info

Title:
A Comparative Study of Dualmicroport and Uniport Videoassisted Thoracoscopic Surgery for Palmar Hyperhidrosis
作者:
陈茂林 崔东** 张卫东 邱瑞兴 钱如林
(河南省胸科医院胸外科，郑州450000)
Author(s):
Chen Maolin;  Cui Dong;  Zhang Weidong;  et al.
Department of Thoracic Surgery, Henan Provincial Chest Hospital, Zhengzhou 450000, China
关键词:
电视胸腔镜手术; 单孔; 交感神经切断术; 手汗症
Keywords:
Videoassisted thoracoscopic surgery; Uniport; Sympathectomy; Palmar hyperhidrosis
文献标志码:
A
摘要:
目的探讨双微孔及单孔胸腔镜治疗原发性手汗症的优缺点。方法回顾性分析2020年1月~2024年2月60例原发性手汗症资料。2022年之前30例行单孔法，之后30例行双微孔法。双微孔组为腋中线2个相距15 cm的3 mm trocar穿刺孔，使用30° 3 mm胸腔镜，单孔组为腋中线6 mm切口，使用30° 5 mm胸腔镜，均行双侧R4交感神经切断。比较2组手术时间、出血量、术后住院时间、术后24 h内疼痛评分、术后并发症、术后代偿性多汗。结果手术顺利，术后即刻双侧手掌温暖干燥，无并发症发生。双微孔组术后疼痛评分更低［(13±08)分vs(18±09)分，t=-2578，P=0012］。2组手术时间［(283±93)min vs (307±82)min］、术中出血量［(62±25)ml vs (70±31)ml］、术后住院时间［1(1~2)d vs 1(1~3)d］、代偿性多汗发生率［33%(10/30) vs 27%(8/30)］和程度差异均无显著性(P>005)。结论双微孔和单孔胸腔镜治疗原发性手汗症均安全、有效，双微孔切口更隐蔽、美观，疼痛更轻。
Abstract:
ObjectiveTo study the advantages and disadvantages of dualmicroport and uniport videoassisted thoracoscopic surgery (VATS) for palmar hyperhidrosis (PH). MethodsA retrospective study was performed on 60 patients with PH from January 2020 to February 2024. Before 2022, 30 patients underwent uniport VATS, and after that, 30 patients were given dualmicroport VATS. For the dualmicroport group, two 3 mm trocar puncture ports were located 1.5 cm apart on the middle axillary line, and a 30° 3 mm thoracoscope was used. For the uniport group, a 6 mm incision on the middle axillary line was made and a 30° 5 mm thoracoscope was used. Both groups underwent bilateral thoracic sympatheetomy at segment of R4. The operation time, blood loss, postoperative hospital stay, levels of pain during the first 24 hours after surgery (Numeric Rating Scale, NRS), postoperative complications, and compensatory sweating were compared between the two groups.ResultsThe procedures were successfully performed. Both hands were warm and dry immediately after surgery without complications occurred in both groups. The NRS score of the dualmicroport group was lower than that of the uniport group ［(1.3±0.8) points vs. (1.8±0.9) points, t=-2.578, P=0012］. There were no significant differences in operation time ［(28.3±9.3) min vs. (30.7±8.2) min］, blood loss ［(6.2±25) ml vs. (7.0±3.1) ml］, postoperative hospital stay ［1 (1-2) d vs. 1 (1-3) d］, or incidence ［33% (10/30) vs. 27% (8/30)］ and grade of compensatory sweating between the two groups (P>0.05).ConclusionsBoth dualmicroport and uniport VATS for PH are safe and effective. The dualmicroport VATS has hidden incision, good cosmetic results, and less postoperative pain.

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备注/Memo

备注/Memo:
基金项目：河南省医学科技攻关项目（LHGJ20200223）**通讯作者，Email：aycuidong@163.com
更新日期/Last Update: 2025-02-27