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

我们计划这项研究的目的是为了更准确地识别胸交感神经干，减少代偿性出汗，这是ETS的主要并发症。对36例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。34例患者在同侧手获得SSR，重复性好。SSR潜伏期为0.7 s~4.0 s，波幅为0.3 mV~10 mV。所有获得SSR的患者在交感神经切除后显示电刺激后SSR的存在。所有患者均获得充分的交感神经切除。无一例发生术后并发症。所有患者都出现了躯干、臀部和下肢的代偿性出汗，不需要治疗。术中监测ETS对评估原发性手汗症患者胸交感神经干阻断程度有重要意义。ETS是一种根治性治疗方法，但其对健康相关生活质量的影响尚未得到研究。采用SF-36健康调查问卷对山口大学附属医院接受ETS手术的15名患者的术前、术后生活质量进行评估。所有患者仅在第2、3肋骨或第3肋骨进行ETS。所有患者均完成了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的得分显著低于日本普通人群，反映了角色-身体、社会功能和角色-情感的显著损害。治疗后，除躯体功能和角色情感外，SF-36评分(0~100分)均有改善。ETS能显著改善重度掌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.