Study Of Hyperhidrosis-related Serological And Prevention And Treatment Of Complications Of Thoracic Sympathetic Modulation

Part ? Study of hyperhidrosis-related serologicalObjective The aim is to find the difference between the hyperhidrosis patients and healthy person by comparison of epinephrine? norepinephrine?acetylcholine?aquaporin 1(AQP1)?aquaporin 2(AQP2)?aquaporin 3(AQP3)?aquaporin 4(AQP4)and aquaporin 5(AQP5)in the serum of them,to clarify the pathophysiological state of hyperhidrosis,and to provide a laboratory basis for the clinical diagnosis of patients with hyperhidrosis.Methods From March 2017 to September 2017,Data and blood specimens(experimental group)of 33 patients with pain in the First Hospital of Jiaxing due to primary hyperhidrosis,And collect data and blood specimens(control group)of 27 healthy medical examiners from the physical examination center of the First Hospital of Jiaxing at the same time.The expression of adrenaline? norepinephrine?acetylcholine aquaporin 1?aquaporin 2?aquaporin 3?aquaporin 4 and aquaporin 5 was measured by enzyme-linked immunosorbent assay(ELISA).Results The expression of adrenaline?norepinephrine?acetylcholine and aquaporin 5 in the experimental group was higher than that in the control group,P <0.05,the difference was significant;There was no significant difference of aquaporin 1?aquaporin 2?aquaporin 3 and aquaporin 4 in the experimental group and the control group;There was no significant difference of adrenaline/acetylcholine and norepinephrine/acetylcholine in the experimental group and the control group.Conclusion The excitability of the sympathetic nervous system and parasympathetic nervous system in patients with hyperhidrosis is higher than that in healthy person,but the excitability of the sympathetic nervous system and parasympathetic nervous system is still balanced within a certain range;Aquaporin 5,a member of the aquaporin family,plays a role in the transport of water molecules in patients with hyperhidrosis.Part ? Prevention and treatment of complications of thoracic sympathetic modulationObjective To reduce the occurrence of the complications,especially the complication of Horner syndrome by summarize the prevention and treatment of complications during thoracic sympathetic modulation treatment of head hyperhidrosis guided by CT.Methods Retrospective analysis of 116 patients with CT-guided thoracic sympathetic modulation for patients with head hyperhidrosis between January 2010 and December 2016 in Jiaxing First Hospital,summarizing related complications and prevention measures,especially the causes of Horner's syndrome and the treatment,summarizing the corresponding prevention and treatment measures.Results 116 patients were successfully puncture to the predetermined target according to the set puncture path(both sides of the R3 above the rib head).Under CT guidance,the puncture process was successfully,and no complications such as pneumothorax,blood pneumothorax and total spinal anesthesia occurred.the incidence of Horner syndrome is higher(9.5%): After injection of local anesthetic plus contrast agent,CT scan showed there are 39 sides of the liquid parallel to the outside of pleural(26 sides)or over(13 sides)R1 above the rib head.CT scan again after the injection of anhydrous alcohol,there are 43 sides of the liquid parallel to the outside of pleural(24 sides)or over(19 sides)R1above the rib head.after the operation,22 sides appeared Horner syndrome,19 of which immediately give physiological saline 5ml into the ipsilateral Satellite ganglion.Within 2 hours Horner's syndrome completely disappeared,while 3 cases were not treated,Horner syndrome lasts for 3 months to 2 years.Conclusion Under the guidance of CT,The incidence of Horner's syndrome in treating head Hyperhidrosis is as high as 9.5%.Immediate injection of 5 ml of saline into the lateral stellate ganglion eliminates this common complication.