脱细胞异体真皮在腋臭术后创面修复中的应用  

Application of Acellular Allogeneic Dermis in Wound Repair after Axillary Osmidrosis Surgery

作　　者：李秀丽[1] 王峻岭[1] 张桂珍[1] 杨正红[1] 李慧[1] LI Xiu-li;WANG Jun-ling;ZHANG Gui-zhen;YANG Zheng-hong;LI Hui(Department of Burn and Plastic Surgery,Cangzhou Central Hospital,Cangzhou 061000,Hebei,China)

机构地区：[1]沧州市中心医院烧伤整形科,河北沧州061000

出　　处：《中国美容医学》2021年第8期32-35,共4页Chinese Journal of Aesthetic Medicine

摘　　要：目的:探讨脱细胞异体真皮修复腋臭患者大汗腺修剪术后创面对周围炎性细胞表达及皮肤坏死情况的影响。方法:选取笔者医院2012年1月-2019年1月收治的腋臭患者100例,均行大汗腺修剪术。根据随机数字表法分成对照组与观察组,各50例。对照组采用自体修剪后刃厚皮片移植修复,观察组采用脱细胞异体真皮与自体刃厚皮复合移植修复。比较两组修复疗效,分别在术后2周、4周采用温哥华瘢痕量表(Vancouver scar scale,VSS)及患者与观察者瘢痕评估量表(Patient and observer scar assessment scale,POSAS)评估两组瘢痕评分,于术后1d、2周采集3ml空腹静脉血,经离心处理后,检测血清白介素-6(IL-6)、白介素-8(IL-8)、超敏C反应蛋白(hs-CRP)水平,并分析两组皮肤坏死发生率。结果:观察组优良率为96.00%显著高于对照组的82.00%,差异有统计学意义(P<0.05)。两组术后4周VSS及POSAS评分均低于术后2周,且观察组显著低于对照组,差异有统计学意义(P<0.05)。两组术后2周血清IL-6、IL-8、hs-CRP显著低于术后1d,且观察组显著低于对照组,差异有统计学意义(P<0.05)。观察组皮肤坏死发生率为4.00%,对照组为14.00%,组间比较差异无统计学意义(P>0.05)。结论:针对行大汗腺修剪术的腋臭患者采用脱细胞异体真皮对患处进行修复,能提高修复效果,进一步改善局部瘢痕症状,并减轻炎症,皮肤坏死率较低。Objective To investigate the effect of acellular allogenic dermis on the expression of inflammatory cells and skin around the wound and skin necrosis in patients with axillary osmidrosis after large sweat gland pruning.Methods 100 patients with axillary osmidrosis admitted to our hospital from January 2012 to January 2019 were treated with sweat gland pruning.According to the random number table method,50 cases were divided into the control group and the observation group.The control group was repaired with autologous split thickness skin graft,and the observation group was repaired with acellular allogeneic dermis and autologous split thickness skin composite graft.Two groups were evaluated by VSS and POSAS at 2 weeks and 4 weeks after operation.3ml fasting venous blood was collected one day after the operation and 2 weeks after the operation.After centrifugation,serum levels of interleukin-6(IL-6),interleukin-8(IL-8)and hypersensitive C-reactive protein(hs-CRP)were detected,and the incidence of skin necrosis in the two groups was analyzed.Results The excellent and good rate of the observation group(96.00%)was significantly higher than that of the control group(82.00%),the difference was statistically significant(P<0.05).VSS and POSAS scores at 4 weeks after surgery in both groups were lower than those at two weeks after surgery,and the observation group was significantly lower than the control group(P<0.05).The serum levels of IL-6,IL-8 and hs-CRP in the two groups were significantly lower than those at one day after operation,and the level in the observation group was significantly lower those that in the control group(P<0.05).The incidence of skin necrosis was 4.00%in the observation group and 14.00%in the control group,there was no significant difference between the two groups(P>0.05).Conclusion For axillary osmidrosis patients undergoing apocrine gland pruning,acellular allogeneic dermis was used to repair the affected area can improve the repair effect,further improve the local scar symptoms,and reduce inf

关 键 词：腋臭 大汗腺修剪术 脱细胞异体真皮 创面修复 皮肤坏死 超敏C反应蛋白 炎症细胞 

分 类 号：R758.741[医药卫生—皮肤病学与性病学]