本文關(guān)鍵詞： 多汗癥 雙側(cè)胸交感神經(jīng)切斷術(shù) 胸腔鏡 局部麻醉 麻醉監(jiān)護(hù)　出處：《實(shí)用中西醫(yī)結(jié)合臨床》2016年05期 　論文類型：期刊論文

【摘要】：目的:探討麻醉監(jiān)護(hù)下局部麻醉單孔胸腔鏡下雙側(cè)胸交感神經(jīng)切斷術(shù)治療多汗癥的可行性及安全性。方法:選擇2013年4月~2015年5月在我院手術(shù)治療的多汗癥患者56例進(jìn)行研究,隨機(jī)分為對照組28例。研究組28例,對照組:在氣管插管全麻下采用5 mm單孔胸腔鏡下進(jìn)行雙側(cè)胸T3~T5交感神經(jīng)干切斷術(shù)治療原發(fā)性多汗癥。研究組:在麻醉監(jiān)護(hù)下局部麻醉采用5 mm單孔胸腔鏡下進(jìn)行雙側(cè)胸T3~T5交感神經(jīng)干切斷術(shù)治療原發(fā)性多汗癥。結(jié)果:所有患者手術(shù)均順利完成。對照組:手術(shù)時間(57.73±12.3)min,麻醉時間(81.33±9.90)min,術(shù)后清醒出手術(shù)室時間(41.59±12.73)min,住院費(fèi)用(8 556.69±1 006.53)元,術(shù)后出現(xiàn)咽喉部不適23例(82%),手汗緩解率100%。研究組:所有患者術(shù)中非氣管插管全麻,手術(shù)時間(56.36±11.97)min,麻醉時間(60.95±11.17)min,術(shù)后清醒出手術(shù)室時間(11.59±4.73)min,住院費(fèi)用(7 831.73±664.95)元,術(shù)后咽喉部不適2例(7%),手汗緩解100%。兩組比較:手術(shù)時間相當(dāng),差異沒有統(tǒng)計(jì)學(xué)意義(P=0.8430.05),研究組麻醉時間少,差異有統(tǒng)計(jì)學(xué)意義(P=0.0140.05),術(shù)后清醒出手術(shù)室時間短,差異有統(tǒng)計(jì)學(xué)意義(P=0.0080.05),住院費(fèi)用少,差異有統(tǒng)計(jì)學(xué)意義(P=0.0410.05),術(shù)后咽喉部不適較少,差異有統(tǒng)計(jì)學(xué)意義(P=0.0000.05)。結(jié)論:麻醉監(jiān)護(hù)下局部麻醉單孔胸腔鏡下雙側(cè)胸交感神經(jīng)切斷術(shù)治療多汗癥的方法是可行、安全的,較氣管插管全麻的麻醉時間短,術(shù)后恢復(fù)快,同時可降低住院費(fèi)用和減少術(shù)后咽喉部不適。
[Abstract]:Objective: to investigate the feasibility and safety of bilateral thoracic sympathetic neurotomy under local anesthesia under local anesthesia under single hole thoracoscopy in the treatment of hyperhidrosis. From April 2013 to May 2015, 56 cases of hyperhidrosis treated in our hospital were studied. They were randomly divided into control group (n = 28) and study group (n = 28). Control group: primary hyperhidrosis was treated with 5 mm single hole thoracoscopic thoracotomy under tracheal intubation under general anesthesia. Mm single hole thoracoscopy was performed for the treatment of primary hyperhidrosis by bilateral thoracotomy with T _ 3N _ 5 sympathetic trunk. Results: all patients were successfully operated on. 57.73 鹵12.3 min. The time of anesthesia was 81.33 鹵9.90 minutes, and the time of waking out of operation room was 41.59 鹵12.73 minutes after operation. The cost of hospitalization was 8 556.69 鹵1 006.53 yuan, 23 cases of pharyngopharynx discomfort occurred after operation. The relief rate of hand sweat was 100. The study group: all the patients received general anesthesia without tracheal intubation during operation, the operative time was 56.36 鹵11.97 minutes, and the anesthesia time was 60.95 鹵11.17 minutes. The time of awake operation room was 11.59 鹵4.73 minutes after operation, the cost of hospitalization was 7 831.73 鹵664.95 yuan, and the postoperative pharynx and larynx discomfort occurred in 2 cases (7 cases). Comparison between the two groups: the operation time was the same, the difference was not statistically significant (P < 0. 843 0. 05), and the anesthesia time of the study group was less than that of the control group. The difference was statistically significant (P < 0. 0140.05). The time of waking out of operation room after operation was short, the difference was statistically significant (P < 0. 0080.05), and the cost of hospitalization was less. The difference was statistically significant (P = 0.0410.05), and there was less pharynx and larynx discomfort after operation. Conclusion: the method of bilateral thoracic sympathetic neurotomy under local anesthesia under single hole thoracoscopy is feasible and safe in the treatment of hyperhidrosis. The anesthesia time of general anesthesia was shorter than that of tracheal intubation, the postoperative recovery was faster, and the hospitalization cost and postoperative pharyngopharynx discomfort could be reduced at the same time.
【作者單位】： 廣東省高州市人民醫(yī)院胸外科;
【分類號】：R614.3
【正文快照】： 多汗癥是一種交感神經(jīng)功能亢進(jìn)導(dǎo)致的障礙性疾病[1],由于皮膚持續(xù)處于潮濕狀態(tài),會導(dǎo)致皮膚易受感染,給患者帶來心理和社交方面的影響,從而嚴(yán)重影響患者的生活質(zhì)量。單孔胸腔鏡下雙側(cè)胸交感神經(jīng)切斷術(shù)是目前治療多汗癥最為有效的方法,該手術(shù)方法主要建立在全身麻醉的基礎(chǔ)上實(shí)施，

本文編號：1488737