Analysis Of Influencing Factors Of Quality Of Life In Patients With Primary Palmar Hyperhiddrosis After Endoscopic Thoracic Sympathectomy

Objective: To evaluate the changes in quality of life(QOL)in patients with primary palmar hyperhidrosis(PPH)after endoscopic thoracic sympathotomy(ETS)and analyze the influencing factors.Methods: From January 2017 to January 2018,243 patients with PPH(118 males and125 females)underwent T3 thoracic sympathectomy in our hospital.The World Health Organization Quality of Life Scale Brief Version(WHOQOL-BREF)was used to evaluate the QOL scores before ETS,1 month after ETS,and 1 year after ETS.By establishing a linear regression model of gender,age,body mass index(BMI),compensatory hyperhidrosis(CH),pain and excessive dryness of palms,the relationship between the postoperative quality of life changes and various factors was studied and revealed.Results: The remission rate of palm hyperhidrosis after ETS was 100%,and there was no recurrence during the 1-year follow-up period.The incidence of complications 1month after surgery and 1 year after surgery were 17.70%(43/243)and 29.22%(71/243),respectively,and the difference was statistically significant(P<0.001).The main complications were CH,excessive dryness of palms,and pain.The total QOL scores of 1 month and 1 year after surgery were higher than those before surgery(63.95±4.42 VS 48.11±1.95,P<0.001),(63.01±4.58 VS 48.11±1.95,P<0.001).The scores of subjective perception of quality of life,subjective perception of health status,physiological domain,psychological domain,and social relationship domain of 1 month and 1 year after operation were higher than those before operation(P<0.05),while there was no significant difference in environmental scores before ETS,1 month after ETS,and 1 year after ETS(P>0.05).Compared with the negative group with CH and pain 1month after ETS,the total QOL score changes decreased by 4.093 and 6.258 respectively.The effect of back CH on the change of QOL total score 1 month after ETS was statistically significant(F=12.893,P <0.001).The mild,moderate,and severe back CH reduced the total QOL score by 3.236,6.472,and 9.708 in 1 month after ETS.Compared with the negative group with CH and pain 1 year after ETS,the total QOL score changes were reduced by 4.773 and 6.774 respectively.Chest CH and back CH had statistically significant effects on the total QOL score changes 1 year after ETS(F=69.578,P<0.001).Mild,moderate,and severe chest CH and back CH reduced the total QOL score changes by 1.804,3.608,5.412,2.400,4.800,and 7.200,respectively,1year after ETS.Conclusion: The application of ETS in the treatment of PPH is safe and effective,and can significantly improve the short-term and long-term QOL scores of patients,and improve all aspects of the QOL.The main factors affecting the QOL score in the first month after the operation are pain and severe back CH.The main factors that affect the quality of life 1 year after ETS are pain,severe back CH and severe chest CH.The one-month follow-up interval cannot fully reflect the impact of ETS surgery on PPH patients,and a follow-up period of at least one year or longer is required.