皮下内镜辅助切割吸引器与小切口修剪术治疗腋臭的比较  

Subcutaneous endoscope assisted suction-curettage shaver versus small-incision scissor for the treatment of axillary osmidrosis

作　　者：王治强 胡雁 柳权 刘琳琳 姜华 杜冉 Wang Zhiqiang;Hu Yan;Liu Quan;Liu Linlin;Jiang Hua;Du Ran(Department of Plastic and Aesthetic Surgery,Yantai Affiliated Hospital of Binzhou Medical University,Yantai 264100,China)

机构地区：[1]滨州医学院烟台附属医院整形美容科,264100

出　　处：《中华整形外科杂志》2020年第9期1029-1033,共5页Chinese Journal of Plastic Surgery

基　　金：山东省医药卫生科技发展计划(2017WS681)。

摘　　要：目的比较皮下内镜辅助切割吸引器与小切口修剪术治疗腋臭的效果与安全性。方法收集2013年5月至2018年5月滨州医学院烟台附属医院整形美容科收治的腋臭患者,共71例(142侧)。38例(76侧)采用皮下内镜辅助切割吸引器切除腋下顶泌汗腺(内镜组),男14例,女24例,年龄18~45岁,平均24岁,病程1~15年,2级6例、3级32例;33例(66侧)采用小切口修剪术进行治疗(修剪组),男9例,女24例,年龄18~42岁,平均25岁,病程1~17年,2级5例、3级28例。内镜组于内镜直视下切割吸引器切除顶泌汗腺。修剪组翻转皮瓣,组织剪直视下修剪。依据Tung分级法进行疗效评价。对并发症情况、疗效和满意度采用卡方检验,对手术的平均时间采用独立样本t检验,比较2组患者差异。结果2组患者均顺利完成手术。内镜组术后并发症发生率为3.95%(3/76),明显低于修剪组的25.76%(17/66),差异具有统计学意义(χ^2=39.699,P<0.001)。内镜组手术时间为(58.212±4.897)min,较修剪组(54.079±6.096)min稍长,但是包扎时间、拆线时间和开始康复锻炼时间都明显较修剪组短,差异均具有统计学意义(P<0.05)。内镜组有效率为100%(75/75)明显高于修剪组的89.39%(59/66),差异具有统计学意义(χ^2=8.479,P=0.004)。内镜组满意度为97.37%(74/76),明显高于修剪组满意度74.24%(49/66),差异具有统计学意义(χ^2=33.102,P<0.001)。结论皮下内镜辅助切割吸引器比小切口修剪术治疗腋臭效果更佳、术后并发症少、康复快、满意度更高。Objective To compare the efficacy and safety of subcutaneous endoscope assisted suction-curettage shaver and small-incision scissor in the treatment of axillary osmidrosis.Methods A total of 71 cases(142 sides)of patients with osmidrosis were treated.Among them,38 cases(76 sides)were treated with subcutaneous endoscope assisted suction-curettage shaver for the resection of apocrine sweat glands,and 33 cases(66 sides)were treated with small-incision scissor.The postoperative recovery was evaluated by Tung grading.The postoperative complications,efficacy,operative time and satisfaction rate were also included in the comparison evaluation.Results The effective rate of the subcutaneous endoscope assisted suction-curettage shaver group was 100%(75/75),which was significantly higher than that of the small-incision scissor group(89.39%,59/66),with a statistically significant difference(χ^2=8.479,P=0.004).Complications in subcutaneous endoscope assisted suction-curettage shaver group(3.95%,3/76)were significantly lower than that in small-incision scissor(25.76%,17/66),χ^2=39.699,P<0.001.The operative time of the endoscope group[(58.212±4.897)min]was slightly longer than that of small-incision scissor group[(54.079±6.096)min].But the dressing time,stitches removal time and rehabilitation exercise time were significantly shorter than those of the small-incision scissor group,with statistically significant differences(P<0.05).The satisfaction rate of subcutaneous endoscope assisted suction-curettage shaver group(97.37%,74/76)was significantly higher than that of the small-incision scissor group(74.24%,49/66),χ^2=33.102,P<0.001.Conclusions Subcutaneous endoscope assisted suction-curettage shaver has more significant efficacy,less postoperative complications,faster recovery and higher satisfaction than small-incision scissor in the treatment of axillary osmidrosis.

关 键 词：内镜 腋窝 汗腺 

分 类 号：R758.741[医药卫生—皮肤病学与性病学]