变换肩关节外展角度在盲、直视下清除大汗腺治疗腋臭的体会  

Angle changes of shoulder joint in the treatment of axillary bromhidrosis by combining blind undermining with direct "pinching and turn-over" pruning

作　　者：王振 张亚男[2] 宋朋朋 程玉 韩景健 马会强[2] 高凤林 WANG Zhen;ZHANG Yanan;SONG Pengpeng;CHENG Yu;HAN Jingjian;MA Huiqiang;GAO Fenglin(Department of Burn and Plastic Surgery,Jining No.1 People's Hospital,Jining 272000,China)

机构地区：[1]济宁市第一人民医院烧伤整形科,山东济宁272000 [2]济宁市第一人民医院医学美容中心,山东济宁272000

出　　处：《中国美容整形外科杂志》2022年第1期41-43,共3页Chinese Journal of Aesthetic and Plastic Surgery

基　　金：济宁市第一人民医院博士基金(2017001)。

摘　　要：目的探讨通过变换肩关节外展角度,盲、直视并用清除大汗腺治疗腋臭的疗效和安全性。方法自2019年9月至2020年7月,济宁市第一人民医院烧伤整形科和医学美容中心收治了38例中重度腋臭患者。术中首先肩关节外展150°,组织剪沿浅表脂肪层与浅筋膜间剥离至腋毛区外约1 cm,眼科小弯剪在盲视下修剪皮瓣下脂肪和大汗腺组织;然后调整肩关节至外展90°,翻转已剪薄的皮瓣,直视下修剪残余大汗腺组织。紧贴切口后缘放置橡皮条引流,八字绷带包扎固定。结果 38例患者无一例出现术后血肿或皮肤坏死。术后1年随访,所有患者均对治疗效果满意。结论采用靠腋后线切口,术中变换肩关节外展角度,盲、直视并用修剪,留置橡皮条引流的小切口手术方法治疗腋臭,效果良好且并发症较少,方法简便易学,值得临床推广应用。Objective To explore the efficacy and safety ofangle changes of shoulder joint in the treatment of axillary bromhidrosis by combining blind undermining with direct "pinching and turn-over" pruning. Methods Thirty-eight patients with moderate and severe axillary bromhidrosis from September 2019 to July 2020 were collected. Firstly, the shoulder joint was abducted at 150°, and subcutaneous dissection was made between the superficial fat layer and the superficial fascia to about 1 cm outside the armpit hair area. The fat and sweat gland tissues under the skin flap were removed under the blind vision using a curved ophthalmic scissors. After the shoulder joint was abducted at 90°, the thin flap was turned-over. The residual apocrine glands tissue was excised under direct vision. The rubber strip drainage was placed close to the posterior edge of the incision. A figure-of-eight compressive dressing was applied. Results No hematoma or necrosis of skin flap was reported. All patients were satisfied with the results during the follow-up of 1 year after operation.Conclusion The incision close to posterior axillary line, angle changes of shoulder joint during the operation, excision through blind and direct vision and rubber strip drainage is an effective technique with few complications for the treatment of axillary bromhidrosis.

关 键 词：腋臭 微创手术 小切口 并发症 

分 类 号：R758.741[医药卫生—皮肤病学与性病学]