摘要
目的比较腋皱襞平行双小切口与单小切口大汗腺剪除术微创根治重度腋臭的临床效果,并明确重度腋臭患者腋窝大汗腺的组织学深度。方法选取2016年11月至2019年2月北京世纪坛医院整形外科门诊收治的重度腋臭患者54例,其中行双小切口大汗腺剪除术27例(试验组),单小切口大汗腺剪除术27例(对照组),试验组中随机选取6例患者行腋窝皮肤组织病理学检查。观察2组术后治疗有效率及术后血肿、表皮坏死、切口裂开、感染及瘢痕等并发症发生率,并进行统计学分析。结果试验组术后有效率为100%(27/27),显著高于对照组的88.89%(24/27)(P<0.05),而试验组术后并发症发生率为11.11%(3/27),显著低于对照组的33.33%(9/27)(P<0.01),差异均有统计学意义。病理学检查显示,大汗腺分泌部集中分布于真皮下方与脂肪交界区及0.5 cm内脂肪浅层,脂肪深层未观察到大汗腺结构。结论腋皱襞平行双小切口大汗腺剪除术微创根治重度腋臭,术式实用有效,临床疗效显著,术中修剪大汗腺的深度应达皮下脂肪层0.5 cm。
Objective To compare the clinical efficacy of trimming apocrine glands with double small axillary fold incisions and single small incision in the radical treatment of severe axillary osmidrosis,and to clarify the histological depth of axillary apocrine glands in patients with severe axillary osmidrosis.Methods Fifty-four patients with severe axillary osmidrosis admitted to Beijing Shijitan Hospital Plastic Surgery Clinic from November 2016 to February 2019 were selected,among whom 27 patients underwent trimming apocrine glands with double small incisions(trial group),27 patients underwent trimming apocrine glandswith single small incision(control group).Six patients in the trial group were randomly selected for axillary skin histopathological examination.The effective rate of postoperative treatment and the incidence of complications such as hematoma,epidermal necrosis,incision dehiscence,infection and scar were observed and analyzed statistically.Results The postoperative effective rate of the trial group was 100%(27/27),significantly higher than 88.89%(24/27)of the control group(P<0.05),while the postoperative complication rate of the trial group was 11.11%(3/27),significantly lower than 33.33%(9/27)of the control group(P<0.01),and there were statistically significant differences in above two aspect comparisons.The pathological examination showed that the secretory part of apocrine glands was concentrated in the junction area between the dermis and fat and the superficial layer of adipose tissue within 0.5 cm.No apocrine gland structure was observed in the deep fat layer.Conclusions The operative method of minimally invasive radical treatment of severe axillary osmidrosis by trimming apocrine glands with double small incisions is practical and effective,and the clinical effect is significant.The depth of trimming the apocrine glands should be 0.5 cm of subcutaneous fat layer.
作者
韩焱福
陶然
杜雪梅
Han Yanfu;Tao Ran;Du Xuemei(Department of Plastic Surgery,Affiliated Beijing Shijitan Hospital,Capital Medical University,Beijing 100038,China;Department of Plastic Surgery,First Medical Center,General Hospital of Chinese PLA,Beijing 100853,China;Department of Pathology,Affiliated Beijing Shijitan Hospital,Capital Medical University,Beijing 100038,China)
出处
《中华整形外科杂志》
CAS
CSCD
北大核心
2020年第6期623-627,共5页
Chinese Journal of Plastic Surgery
基金
2020年度军队医学科技青年培养计划孵化项目(20QNPY097)。
关键词
微创手术
顶泌汗腺
腋臭
治疗结果
病理
Minimally invasive surgical procedures
Apocrine glands
Bromhidrosis
Treatment outcome
Pathology
