夏少锋

[摘要] 目的 探討手汗症胸腔镜交感神经干切断术后不留置胸腔引流管对患者术后康复的影响。 方法 回顾性选取2019年10月至2020年10月本院手汗症患者100例，依据是否留置胸腔引流管分为留置胸腔引流管（留置组）、不留置胸腔引流管组（不留置组）两组，每组各50例，比较两组患者的疼痛程度、病情严重程度、手术时间、住院时间、术后并发症发生情况、生活质量、满意度。 结果 不留置组患者的VAS评分、HDSS评分均显著低于留置组（P<0.05），手术时间、住院时间均显著短于留置组（P<0.05）。不留置组患者的术后并发症发生率为38.0%（19/50），显著低于留置组的44.0%（22/50）（P<0.05）。不留置组患者手术后较手术前的仪态、工作或学习、日常行为、社会心理、社会交际评分及总分降低幅度均显著高于留置组（P<0.05）。不留置组患者的满意度为94.0%（47/50），显著高于留置组的74.0%（37/50）（P<0.05）。 结论 手汗症胸腔镜交感神经干切断术后不留置胸腔引流管较留置胸腔引流管更能促进患者术后康复。

[关键词] 手汗症;胸腔镜交感神经干切断术;不留置胸腔引流管;术后康复;并发症;生活质量

[中图分类号] R655.2          [文献标识码] B          [文章编号] 1673-9701（2021）32-0063-04

[Abstract] Objective To explore the effect of no indwelling thoracic drainage tube after thoracoscopic sympathetic trunk amputation on postoperative rehabilitation of patients with palmar hyperhidrosis. Methods A total of 100 patients with palmar hyperhidrosis in our hospital from October 2019 to October 2020 were retrospective selected and divided into two groups，with 50 patients in each group， according to whether the thoracic drainage tube was indwelling（the indwelling group） or not （the no indwelling group）.The degrees of pain and severity of disease，durations of operation，lengths of hospital stay， incidences of postoperative complications， quality of life and satisfactions of patients in the two groups were statistically analyzed. Results The VAS score and HDSS score in the no indwelling group were significantly lower than those in the indwelling group（P<0.05）， and the duration of operation and the length of hospital stay were significantly shorter than those in the indwelling group（P<0.05）.The incidence of postoperative complications in the no indwelling group was 38.0%（19/50） which was significantly lower than 44.0%（22/50） in the indwelling group（P<0.05）.The reductions of deportment，work or study，daily behavior， social psychology and social communication scores and the total scores in the no indwelling group after surgery were significantly higher than those in the indwelling group（P<0.05）. The satisfaction of patients in the no indwelling group was 94.0%（47/50）， which was significantly higher than 74.0%（37/50） in the indwelling group（P<0.05）. Conclusion The postoperative recovery of patients with palmar hyperhidrosis after thoracoscopic sympathetic trunk amputation was improved by the no indwelling thoracic drainage tube compared with the retention of the thoracic drainage tube.

[Key words] Palmar hyperhidrosis; Thoracoscopic sympathetic trunk amputation; No indwelling thoracic drainage tube; Postoperative rehabilitation; Complication; Quality of life

原發性手汗症是一种多汗症，在临床较为常见，主要临床症状为手掌大量出汗，或合并脚掌及腋窝多汗[1]。现阶段，胸腔镜下胸交感神经干切断术治疗手汗症疗效肯定，其具有较小的创伤、较短的手术时间，但是通常情况下，其术中留置的胸腔引流管会引发患者疼痛，进而造成患者不敢深呼吸、不能有效咳嗽咳痰，从而导致肺部感染、肺不张发生的增加、住院时间的延迟、治疗费用的增加[2]。……