刮除法和剪除法去除腋窝大汗腺的比较  

Comparison between resection and curettage on removing apocrine sweat glands

作　　者：黄威 邱涛 李淼 

机构地区：[1]阳军区总医院,整形外科,辽宁沈阳沈110016

出　　处：《中国美容整形外科杂志》2012年第12期719-721,共3页Chinese Journal of Aesthetic and Plastic Surgery

摘　　要：目的 比较两种常用治疗腋臭的手术方法即刮除法和剪除法的疗效.方法 在患者的腋部注射肿胀麻醉液,在腋窝中央切开长约1cm的切口,用剪刀进行腋窝皮下分离.用刮匙进行皮下搔刮至皮肤呈现紫色,然后将切口适当延长,皮肤翻转.观察大汗腺刮除情况,沿切口边缘剪除1.5mm宽的一小条皮肤做组织学检查.用剪刀剪除大汗腺和部分真皮至形成厚中厚皮片.止血后缝合伤口,剥离区域打包加压包扎.结果 自2009年7月至2011年12月,用此种方法进行42例手术.刮除手术完成后,翻转皮瓣时均可见真皮层深面有粉红色的大汗腺组织残留;病理检查也发现刮除后有腺体残留.术后随访经过刮除和剪除法治疗的患者3～12个月,有效率为97.6%.出现血肿3例,伤口延期愈合4例,复发1例.结论 应用剪刀剪除法比单纯刮除法去除大汗腺更彻底.Objective To compare the results of removing apocrine sweat glands by resection and curettage for osmidrosis treatment. Methods Under tumescent anesthesia, 1 cm incision was made at the middle line of axillary fossa. The subcutaneous dissecton was performed by scissors and scraping was made by a curette to present purple color of skin. After scraping apocrine sweat glands, the incision was lengthened and the flap was turned over. A piece of skin, 1.5 mm width, was harvested for histology examination. Then the flap was cut into full thickness skin. The wound was sutured and performed the pressure dressing after hemostasis. Re- sults From July 2009 to December 2011, 42 patients underwent this operation. There were some apocfine sweat glands residue through macroscopic examination and histological examination after scraping. These apo- cfine sweat glands showed pink color underneath dermis. These patients were followed up for 3 to 12 months, and the efficacy of apocrine sweat gland resection was 97.6%. There were a few complications except for 3 cases with hematoma, 4 cases with delayed healing and 1 case with recurrence. Conclusion Resection by scissors can remove apocrine sweat glands more completely than that of curettage.

关 键 词：腋臭 刮除 剪除 比较 

分 类 号：R622[医药卫生—整形外科]