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目的观察膀胱镜下双侧单孔胸交感神经链切断术治疗手汗症的疗效。方法 18例中至重度手汗症患者,通过膀胱镜监视,切断双侧胸交感神经链(T_3、T_4)。术后随访2个月~2年,观察有无代偿性多汗及程度,有无复发及满意度。结果所有病例手术顺利完成,手术时间25~90(44.6±20.2)min,术中出血1~10(6.3±3.6)ml,术后住院时间(2.3±0.7)d。术后5例出现胸背部代偿性多汗,其中4例轻度,1例中度,后期随访有逐渐减轻趋势,无复发病例。结论采用4mm膀胱镜进行双侧单孔胸交感神经链切断术(T_3、T_4)操作简便,安全、可靠,手术效果好,术后并发症在可接受范围,切口瘢痕小,值得推广。
Objective To observe the curative effect of cystoscopic bilateral single-hole sympathectomy on palmar hyperhidrosis. Methods Eighteen patients with moderate to severe hyperhidrosis were monitored by cystoscopy to cut bilateral thoracic sympathetic chain (T 3, T 4). The patients were followed up for 2 months to 2 years to observe the degree of compensatory hyperhidrosis, whether recurrence and satisfaction. Results All the cases were successfully performed. The operation time was 25-90 (44.6 ± 20.2) min, the intraoperative bleeding was 1 ~ 10 (6.3 ± 3.6) ml and the postoperative hospital stay was (2.3 ± 0.7) d. Postoperative 5 patients showed compensatory hyperhidrosis of the chest and back, of which 4 were mild, 1 moderate, follow-up with a gradual reduction trend, no recurrence. Conclusions Bilateral single-hole thoracic sympathectomy (T_3, T_4) with 4mm cystoscopy is simple, safe, reliable and effective. The postoperative complications are within the acceptable range and the incision scar is small. It is worth popularizing.