| Objective To explore the clinical effect and clinical value of 3mm thoracoscope combined with needle electroco agulation hook thoracic sympathectomy in the treatment of primary palmar hyperhidrosis.Methods The clinical data of 70 patients with primary palmar hyperhidrosis who underwent thoracoscopic thoracic sympathectomy in our hospital from September 2017 to July 2021 were collected and analyzed retrospectively.Among the 70 patients,there were 44 males and 26 females.Among them,29 patients were treated with 3mm video-assisted thoracic sympathectomy combined with needle electrocoagulation hook thoracic sympathectomy were set as the observation group,including 18 males and11 females,aged 22.00（19.50,27.00）years,and 41 patients were treated with conventional thoracoscopic thoracic sympathectomy as the control group,including 26 males and 15 females,aged 22.00（18.00,26.50）years.The patients in both groups were operated by the same medical group.Collate the operation-related results of the two groups,the baseline data,operation time,intraoperative blood loss,postoperative hospital stay,postoperative pain index and hospitalization cost,postoperative white blood cell count,neutrophil percentage and other inflammatory indexes,postoperative water intake time,time to get out of bed after operation,heart rate 12 hours after operation,blood oxy gen saturation 12 hours after operation（no oxygen inhalati on）and occurrence of intraoperative an d postoperative complications were compared between the two groups.The postoperative follow-up survey of the patients was carried out by coming to the hospital for revisit,network contact and so on.Results All the patients in both groups completed the operation successfully,and there was no conversion to thoracotomy and secondary operation,and no emergency such as massive hemorrhage during operation.The patient returned to the ward safely after operation.The symptoms of hand sweat were significantly improved in both groups after operation.Compared with the control group,the observation group was shorter in operation time[23.00（21.00,26.00）min vs.26.00（23.50,28.50）min,P=0.002]and postoperative hospital stay[2.00（1.00,2.00）d vs.2.00（1.00,3.00）d,P=0.011].Intraoperative blood loss[5.00（3.00,5.00）ml vs.6.00（5.00,10.00）ml,P=0.003],postoperative pain index[2.00（1.00,3.00）vs.3.00（2.00,3.00）,P=0.020],hospitalization cost[（14207.90±725.008）yuan vs.（15085.90±827.151）yuan,P<0.001]and postoperative inflammation index:White blood cell count[（13.00±2.40）×10~9 vs.（14.47±2.05）×10~9,P=0.010]The percentage of neutrophils（75.62%±7.77%vs.79.97%±7.12%,P=0.020）was significantly lower than that in the control group.There was no significant difference in the incidence of major occurrence of intraoperative and postope rative complications and adverse consequences between the two groups（P>0.05）.In the evaluation of 12 hours after operation,the time of getting o ut of bed[2.00（1.00,2.00）h vs.2.00（2.00,3.00）h,P=0.014],the time of drinking water[1.50（1.00,2.00）h vs.2.00（1.00,3.00）h P=0.014]in the observation group were shorter than those in the control group,and the heart rate at 12 hours after operation[（81.83±15.25）bpm/min vs.（91.07±15.08）bpm/min,P=0.015]was lower than that in the control group.There was no significant difference in blood oxygen saturation 12 hours after operation between the two groups[97.00%（95.50%,98.00%）vs.97.00%（96.00%,98.00%）,P=0.981].Conclusion Compared with conventional thoracoscopic thoracic sympathectomy,3mm video-assisted thoracic sympathectomy combined with needle electrocoagulation hook thoracic sympathectomy can significantly shorten the operation time,reduce postoperative pain,enhance patients’coop eration with perioperative treatment and rehabilitation exercise,accelerate the speed of postoperative recovery and reduce patients’expenditure in hospital.It is an in-depth application of the concept of EARS and minimally invasive surgery in the treatm ent of thoracic surgical diseases,and is worth popularizing in clinical practice. |
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