微创搔刮法腋臭根治术的病理学观察及术式探讨  

Pathological observation and operative discussion on the treatment of osmidrosis using subcutaneous curettage with mini-invasion

作　　者：刘玉磊[1] 房晶[2] 陈振雨[2] 张维娜[2] 冷向峰[2] 

机构地区：[1]山东省寄生虫病防治研究所整形美容中心,山东济宁272033 [2]青岛大学医学院附属医院整形美容科

出　　处：《中国美容整形外科杂志》2011年第7期416-418,共3页Chinese Journal of Aesthetic and Plastic Surgery

摘　　要：目的通过观察腋臭患者腋部顶泌汗腺分布的范围和层次，探讨改良锐性腋臭搔刮术的疗效。方法切取患者腋部皮肤及皮下组织行病理检查，采用HE染色，在显微镜下观察顶泌汗腺分布的范围和层次。白2005年3月至2010年3月，采用改良微创锐性腋臭搔刮术对156例（312侧）患者进行了治疗。结果出现血肿者5例（6侧，占2．0％），积液者5例（5侧，占1．6％），局部表皮坏死者14例（16侧，占5．0％），均于术后1周内发生，给予对症处理后，于术后2周内愈合；余者均I期愈合（占91．3％）。无感染、全层皮肤坏死以及因术区瘢痕或挛缩致上肢活动受限者出现，术后随访142例患者6个月以上，未见复发者。结论改良微创锐性腋臭搔刮术可有效地去除顶泌汗腺，且未破坏真皮层，减轻了对皮肤血供的影响，降低了并发症发生率和复发率。Objective To investigate the curative effect of modified acute curettage on osmidrosis by observing the extent and layers of apocrine sweat gland distribution in armpit from the patients with osmidrosis. Methods The skin and hypodermia of armpit were taken and then they were detected by pathological examination with HE staining. The extent and layers of armpit apocrine sweat gland in armpit were observed under microscope. From March 2005 to March 2010, 156 patients （312 sides） were treated by using modified acute curettage of osmidrosis with micro-invasion. Results All patients （91.3%） healed primarily except 5 patients （6 sides） with haematoma （2.0%）, 5 patients （5 sides） with hydrops （ 1.6% ）, and 14 patients （ 16 sides） with region epidermis necrosis （5.0%） at 1 week postoperatively, which were healed by the right treatments at 2 weeks postoperatively. After more then 6 months following up in 142 patients, all cases were satisfied without infection, full- thickness cutaneous necrosis, and upper limb limitation of motion caused by postoperative scars contracture or recurrence. Conclusion The modified acute curettage with mini-invasion for treating osmidrosis can effectively remove the apocrine sweat gland, avoid dermis layer destruction, lighten influence of skin blood supply and also degrade incidence rates of complications and recurrence.

关 键 词：腋臭搔刮术 顶泌汗腺 病理学 改良法 

分 类 号：R622[医药卫生—整形外科]