Sympathetic skin response evoked by electrical stimulation of the thoracic sympathetic trunk as intraoperative monitor of endoscopic thoracic sympathectomy. -Health-related quality of life among patients with palmer hyperhidrosis who underwent endoscopic

本研究的目的是为了更准确地识别胸交感神经干，减少ETS的主要并发症代偿性出汗。对36例经胸交感神经干电刺激后的交感神经皮肤反应（SSR）进行了监测。在34例患者的同侧手部获得了重复性SSR。SSR潜伏期为0.7~4.0s，波幅为0.3~10mV。所有获得SSR存在的患者在交感神经切除术后电刺激后均显示SSR不存在。所有患者均行交感神经切除术。未发生术后并发症。所有患者均出现躯干、臀部和下肢代偿性出汗，无需治疗。术中监测这种方法是非常有用的评估胸交感神经干的阻塞程度的原发性手汗症患者接受ETS。ETS是一种治愈性治疗，但其对健康相关的生活质量的影响还没有研究。采用SF-36健康调查表对15例在山口大学医院接受ETS的患者进行术前和术后生活质量评估。所有患者均在第2和第3肋骨或仅在第3肋骨进行ETS。<nd><rd><rd>所有患者均完成ETS，效果良好。所有患者均出现代偿性出汗。无严重并发症和围手术期死亡。在ETS之前，SF-36评分显著低于一般日本人群，反映了角色-身体、社会功能和角色-情感的显著损害。ETS后SF-36评分（0-100分）除躯体功能和情感角色外，其他各量表评分均较ETS前有改善。ETS能显著改善重度手汗症患者的健康相关生活质量。

We planed this study in a purpose to identify the thoracic sympathetic trunk more surely and to reduce compensatory sweating that is the main complication of ETS. Sympathetic skin respbnces (SSRs) following electrical stimulation of the thoracic sympathetic trunk were monitored in 36 patients who underwent ETS. SSRs were obtained at the ipsilateral hand with reproducibility in 34 patients. The latency and the amplitude of SSRs ranged from 0.7s to 4.0s and from 0.3mV to 10mV respectively. All patients obtained the presence of SSRs showed the absence of SSRs following electrical stimulation after sympathetectomy. Adequate sympathectomies were achieved in allpatients. No postoperative complications were not encountered. All patients developed compensatory sweating of the trunk, hip, and lower limbs, which didn't need treatments. Intraoperative monitoring of this method is very useful for evaluating the degree of block of thoracic sympathetic trunk in patients with primary palmar hyperhidrosis who undergo ETS.ETS is a curative therapy, but its effect on health-related quality of life has not been studied. The SF-36 Health Survey was used to assess quality of life before operation and after operation in 15 patients underwent ETS at Yamaguchi Univ.Hospital. All patients underwent ETS at the 2^<nd> and 3^<rd> rib or 3^<rd> rib only. ETS was completed in all patients with adequate effects. Compensatory sweating as complication were seen in all patients. There were no severe complications and perioperative deaths. Before ETS, the SF-36 scores were significantly lower than in the general Japanese population, reflecting significant impairment in role-physical, social functioning, and role-emotional. After ETS, the SF-36 scores (0-100scoring) were improved on all scales except for physical functioning and role-emotional. ETS can significantly improve the health-related quality of life in patients with severe palmer hyperhidrosis.