T4 Sympathectomy for Palmar Hyperhidrosis: An Effective Approach That Simultaneously Minimizes Compensatory Hyperhidrosis

胸腔內視鏡交感神經手術是目前國際公認用來治療多汗症的最好方法。然而迄今國內、外大部份的醫師仍繼續使用第二或第三交感神經切除術來治療手汗症，結果是造成相當嚴重的轉移性或代償性的流汗，患者不勝困擾。本文作者依據林氏交感神經疾病分類法，以第四交感神經切除術來治療84位手心多汗症患者，追蹤18至42個月後，其成功率達100%，並無復發。其中只有2位患者有輕微而且完全可接受的代償性多汗。所以，所有病人對手術的結果都非常滿意。第四交感神經手術用來治療手心多汗症不只有效，其術後之代償性多汗之發生率亦可降至最低。使患者能正常工作及享受與常人一般的社交活動。本文除報導84位患者之手術結果外，第四與第二及三交感神經手術之差異及機轉，亦一併討論之。

關鍵字

交感神經手術；多汗症

並列摘要

Compensatory hyperhidrosis (CH) is the most troublesome side effect after T2 sympathectomy for palmar hyperhidrosis (PH). The aim of this study was to evaluate whether T4 ganglion interruption for PH is an effective approach that can simultaneously minimize the rate of CH. Between July 2001 and July 2003, 84 PH patients undergoing bilateral thoracoscopic T4 sympathectomy were followed up in the outpatient clinic and by telephone questionnaire. Rates of success, regret, CH, recurrence, and complications were recorded. The follow-up period ranged from 18 to 42 months. All excessive hand sweating was stopped. Only two patients had mild CH that did not affect their daily activities. No patients had recurrence or regret. The only other complication was that four patients had postoperative minimal residual pneumothorax, which needed no treatment. All patients were satisfied with the outcome. T4 sympathectomy was an effective method to cure PH. The success rate was 100%. The rate of CH was remarkably low compared with T2 sympathetic ganglionic interruption.

並列關鍵字

hyperhidrosis ； sympathectomy

國際替代計量

T4 Sympathectomy for Palmar Hyperhidrosis: An Effective Approach That Simultaneously Minimizes Compensatory Hyperhidrosis

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