胸腔鏡交感神經鉗夾移除術後手汗之恢復－－皮膚交感反應與臨床評估之比較

Recovery of Hand Sweating After Thoracoscopic Sympathetic Clip Removal--Comparison of Sympathetic Skin Response with Clinical Evaluation

20位已接受胸腔鏡交感神經鉗夾移除術之病人被要求回來做術後追蹤。他們分別接受皮膚交感反應之測驗以及回答有關手汗恢復狀況之自評問卷。結果顯示，對於手汗症病人在第一次胸腔鏡交感神經鉗夾術後之三個月內如果再接受鉗夾移除手術，其手汗之完全回復是肯定的。皮膚交感反應與臨床上之手汗恢復有一致性的有45%。另外之55%卻發現兩者之結果並無一致關聯性。因此在臨床上皮膚交感反應之測驗並無法用來評估交感神經鉗夾移除手術後之手汗恢復。

Objective: The introduction of endoscopic thoracic sympathectomy by clamping (ETSC) creates a possibility of sympathetic function recovery via the procedure of clamping clip removal. The recovery is individualized. Thus, a correlation of skin sympathetic response (SSR) with self evaluation of hand sweating recovery was evaluated. Patients and Methods: 20 patients who underwent thoracoscopic sympathetic clip removal were followed up to evaluate the skin sympathetic response (SSR) by using Medelec Sapphire Ⅱ as well as answering the questionnaire, which was designed to assess the degree of hand sweating recovery in the patients' judgments. Results: The result revealed that hand sweating recovery was definite when clips were removed within 3 months in succession of the first operation. Forty five percent of the patients had their SSR results correspond well with the subjective clinical evaluation of sweating recovery. No appropriate correlation was found in 55% of the patients. Discussion: In conclusion, the SSR is not a clinically appropriate or accurate tool to evaluate quantitative sweating function recovery.